Ann Rehabil Med.  2023 Feb;47(1):52-67. 10.5535/arm.22126.

Outcomes of a Multi-Modal Hospital-Associated Home-Based Cancer Prehabilitation Program

Affiliations
  • 1Department of Rehabilitation Medicine, Changi General Hospital, Singapore

Abstract


Objective
To assess the impact of a “one-stop”, multi-modal, hospital-associated-home-based prehabilitation model, helmed by a small core team, on newly diagnosed gastrointestinal and urological cancer patients planned for surgery.
Methods
This is a retrospective study in a tertiary public hospital, involving all newly diagnosed gastrointestinal and urological cancer patients planned for surgery. The primary outcome measure was the 6-minute walk test (6MWT). Other outcomes included physical, psychological and quality-of-life measures, and patient satisfaction surveys, taken at baseline, pre-operatively (post-prehabilitation), and at 3 months post-operatively.
Results
When comparing the baseline to pre-operatively (post-prehabilitation), there was a statistically significant improvement in the 6MWT (21.52 m, p<0.001), 30-Second Sit to Stand test (STS) (1.08 repetitions, p<0.001), Timed Up and Go test (TUG) (0.83 seconds, p=0.014) and Hospital Anxiety and Depression Scale (HADS) (total score 1.77, p<0.001). These were sustained (6MWT: 0.22, p=0.964; STS: 0.08 repetitions, p=0.863; TUG: 0.04 seconds, p=0.939) or further improved (HADS total score 2.06, p=0.003) at 3 months post-operatively. There was also a statistically significant improvement in the EuroQol-5 dimension health score (health-related quality-of-life measure) from baseline to 3 months post-operatively (7.04 points, p=0.001), with more than 90% overall patient satisfaction reported.
Conclusion
Prehabilitation applied via our model resulted in significant improvements in functional capacity, psychological and quality-of-life outcomes, sustained at 3 months post-operatively, and is a feasible and effective approach that is well-received by our patients.

Keyword

Cancer; Prehabilitation; Delivery of healthcare; Integrated

Figure

  • Fig. 1. Results of patient satisfaction survey (pre-operative). Survey items: (1) This program has given me relevant knowledge for lifestyle changes that will benefit my health. (2) This program had caused me to increase my physical activity level. (3) This program had caused me to be more conscious of my nutrition. (4) Overall, I am satisfied with the interaction I had with the prehabilitaion doctor. (5) Overall, I am satisfied with the interaction I had with the prehabilitaion coordinator. (6) Overall, I have benefitted from this program. (7) I will recommend this program to other patients if they are suitable.

  • Fig. 2. Results of patient satisfaction survey (post-operative). Survey items: (1) This program has given me relevant knowledge for lifestyle changes that will benefit my health. (2) This program had caused me to increase my physical activity level. (3) This program had caused me to be more conscious of my nutrition. (4) Overall, I am satisfied with the interaction I had with the prehabilitaion doctor. (5) Overall, I am satisfied with the interaction I had with the prehabilitaion coordinator. (6) Overall, I have benefitted from this program. (7) I will recommend this program to other patients if they are suitable.


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