PreHabProgramme: A multi-modal approach to prehabilitation in patients undergoing major surgery



The proposed project represents the first collaboration between the two Bristol Biomedical Research Units, Nutrition and Cardiovascular (the CTEU is part of the latter), as well as with the Centre for Exercise, Nutrition and Health Sciences (CENHS).  This programme aims to develop a multi-component prehabilitation intervention (including dietary, exercise, psychological and physiological components) to be used before surgery in people undergoing major surgery for cancer, with the aim of improving patient outcomes post operatively and supporting enhanced recovery pathways. The project includes a systematic review to identify the evidence base for prehabilitation, the establishment of a cohort of patients who undergo preoperative assessment (POA) to characterise the patient population and pre-operative practice and management, and a scoping exercise with local patient and public involvement (PPI) research groups to explore the acceptability and feasibility of the potential intervention components. We will identify appropriate content and structure for the intervention using the findings of the systematic review (work package 1) and characteristics of the patient population (work package 2).  We will conduct a preliminary scoping exercise (two focus group meetings) with established PPI groups (colorectal and prostate cancer) in the Bristol NIHR Nutrition Biomedical Research Unit to explore the acceptability and feasibility of the intervention components which will be incorporated into the intervention design. Prehabilitation is potentially relevant to cardiac surgery and, if our proposed project is funded and conducted successfully, we will explore avenues for extending this work to cardiac surgery patients.

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