Adapting prehabilitation to meet changing demands during the COVID-19 pandemic: A feasibility study

Introduction: Traditionally, prehabilitation was delivered face-to-face (F2F) to optimise patients’ peri-operative function. Social distancing measures to reduce transmission during the pandemic have restricted F2F consultations. We were able to adapt our service to meet the changing demands. Virtual prehabilitation (VP) was launched to continue the benefits of prehabilitation and to reduce social isolation and anxiety. We aimed to assess the feasibility and present the initial findings of switching to a digital platform. Methods: 9 patients had undergone VP during a 2-month period, which comprised of video-guided exercise, telephone-delivered education on nutrition, psychosocial support and medical optimisation. 2 patient-reported outcomes, the Hospital Anxiety and Depression Scale (HADS) and the Physical Activity Enjoyment Scale (PACES), were measured prior to and after prehabilitation. Cohort observational data was prospectively collected for patients undergoing VP and was compared against those who had undergone F2F sessions before the pandemic. Data was compared with a Wilcoxon signed-rank test. Results: The 9 VP patients reported 100% adherence to the programme. The lower HADS scores and increased PACES scores suggests there is increased patient satisfaction following enrolment in the VP programme. Analysis of pre- and post-surgery outcomes did not identify statistically significant differences in both the VP and F2F patients. Discussion: VP has demonstrated high rates of user acceptability and similar effects to F2F sessions. We should continue VP beyond the pandemic to improve uptake amongst patients who would have previously turned down prehabilitation. Conclusion: VP is feasible and associated with comparable patient-reported outcomes to F2F programmes.