Effectiveness of introducing a health care application for prehabilitation in patients undergoing major hepatobiliary-pancreatic surgery: a pilot study.

Purpose: Prehabilitation is known to improve outcomes of gastrointestinal surgery; however, the issue of low adherence during the waiting period for surgery remains unresolved. This study evaluated the effectiveness and feasibility of a newly developed mobile health application, "Preha," designed to support home-based prehabilitation.

Methods: A single-group pilot study involving patients scheduled for major hepatobiliary-pancreatic (HBP) surgery for malignancy between March 2023 and September 2024 was conducted. The patients downloaded the Preha application, and there was no direct intervention from the medical staff during the preoperative period. The application recorded step counts, moderate-intensity exercise times, and squat counts. Adherence was defined as meeting at least one of the following: ≥ 5,000 steps/day, ≥ 10 min/day of ≥ 3 METS activities, or ≥ 30 squats/day, for more than three days per week.

Results: Among 30 eligible patients, 21 (median age, 67 years) were included in the analysis. During prehabilitation, 52% achieved the step goal, 67% met the exercise time target, and 33% completed the squat goal.

Conclusions: The "Preha" application facilitated good adherence to home-based prehabilitation without direct intervention, indicating its feasibility and potential as a perioperative support tool for patients undergoing HBP surgery. Trial registration https://jrct.niph.go.jp/ ; registration number: jRCTs042220106.