Tailored prehabilitation

In order to keep prehabilitation care affordable, it's important to provide tailored care. The method of delivery is also crucial for the success of prehabilitation. Not every patient requires supervised training. Some patients suffice with lifestyle advice through a mobile app, while others do require supervised guidance from a healthcare professional.

In this project, we will develop "prehabilitation phenotypes" for candidates based on their personal characteristics. By distinguishing these subgroups, we can then determine the most suitable form of support (such as supervised, digital, or blended) for each phenotype. Using these prehabilitation phenotypes, healthcare professionals will have practical guidelines to prescribe tailored prehabilitation care. This approach hits two birds with one stone: personalized and affordable care.

We will perform a cross-sectional data analysis involving two existing datasets.

1. Beter Voorbereid (Be Prepared) is a multicenter Randomized Controlled Trial (RCT) assessing the impact of a mobile application. This app provides patients with advice both before and after their surgery, focusing on optimizing their lifestyle and managing pre-operation stress. This project received funding from SIA RAAK MKB.

2. PAM-ONCO is an observational study conducted at the UMC Utrecht, examining the trajectory of physical activity and physical functioning in patients undergoing gastrointestinal oncological surgery.

15 May 2022 - 31 December 2023

This project, conducted in collaboration with UMC Utrecht, comprises several phases:

Phase 1: Determinants for Analysis
Based on consensus, determining which variables could significantly influence the support provided to patients in the preoperative phase. Phase 1 involves organizing 1 or 2 consensus meetings with experts to finalize the list of variables.
Phase 2: Analyses
Standardizing and merging the variables (from Phase 1) obtained from both studies for data analysis. Plans for cluster analyses will be discussed with experts in this field and optimized based on their advice. Subsequently, analyses will be conducted to form phenotypes.
Phase 3: Comparing Clinical Outcomes and Patient Characteristics between Phenotypes
After determining the phenotypes, comparing clinical outcomes and patient characteristics among them. A more detailed description of patient characteristics within each phenotype will be created. This description of the phenotypes serves as the basis for the next phase.
Phase 4: Determining Which Phenotypes May Benefit from Which Interventions and Guidance
Four focus groups (2 with patients and 2 with experts) will determine the type of support/guidance and prehabilitation interventions suitable for the different phenotypes identified in Phase 2.