Feasibility and Acceptability of an App-Based, Multimodal Prehabilitation Program for Women Undergoing Surgery for Gynaecological Cancer.

Abstract

IntroductionPrehabilitation aims to optimise functional capacity, nutritional status, and mental wellbeing, to minimise surgical morbidity and enhance recovery. Hospital-based prehabilitation programs may face practical barriers, such as distance, time, and cost of travel. App-based prehabilitation may therefore offer a practical solution.ObjectiveThe aim of this study was to assess the feasibility, acceptability, and safety of introducing an app-based prehabilitation program into the standard care for women undergoing gynaecological cancer surgery.MethodsThis was a feasibility study performed as part of a prehabilitation service development project for women undergoing gynaecological cancer surgery between April 2024 and May 2024. Women were approached to trial the 'Surgery Hero' prehabilitation app prior to surgery, which was a multimodal app-based intervention including physical exercise, nutrition, and mental wellbeing through information modules, videos, and real-time access to a health coach. Feasibility was assessed through recruitment, activation, participation, and drop-out rates, and adverse events were monitored. Acceptability was assessed through participant satisfaction scores, and semi-structured interviews with thematic analysis of facilitators and barriers to program participation.ResultsFifteen licenses were available and successfully utilised, with a recruitment rate of 58.6% and an activation rate of 88.2%. The participation rate was 93.3% and the mean engagement rate was 76.3%. No adverse events were reported. The mean overall program satisfaction score was 4.5 out of 5. Participants felt motivated to participate and were reassured by the coaching calls and information provision. However, they felt limited by the short preoperative interval and their current state of health.ConclusionsApp-based prehabilitation appears to be a feasible, acceptable, and safe option for women undergoing surgery for a gynaecological cancer. However, further studies are needed to confirm these findings.