Research Priorities in Prehabilitation for Patients Undergoing Cancer Surgery: An International Delphi Study
Pratik Raichurkar, Linda Denehy, Michael J. Solomon, Cherry Koh, Neil Pillinger, Sophie Hogan, Kate McBride, Sharon Carey, Jenna Bartyn, Nicholas Hirst, Daniel Steffens, Prehabilitation Expert Collaborative, Jonathan P. Allen, Kevin Ancog, Eva Angenete, Nabila Ansari, Fabio Ausania, Anna Beaumont, Christian M. Beilstein, Frederik Berrevoet, Ianthe Boden, Kimberley Bostock, Janine Bothe, Birgitte Brandstrup, Louise Brennan, Kilian G. M. Brown, Sorrel Burden, Crystal Burgess, Elaine M. Burns, Francesco Carli, Vinícius Cavalheri, Wim Ceelen, Tyler R. Chesney, David A. Clark, Kari Clifford, Kelcie Cole, Thomas Collyer, Robert Copeland, Roland S. Croner, Jessica Crowe, I. R. Daniels, Gerard Danjoux, June Davis, Caitlin Davis, Mayke de Klerk, Tina Decorte, Jan Willem T. Dekker, Andreas Denys, Liesbeth Desender, Pieter Dries, Declan Dunne, Lara Edbrooke, Linda Edgar, Sabry Eissa, Dominique Engel, Martyn Evans, Rhonda Farrell, Alice Finch, Aisling Fleury, Patrice Forget, Nader Francis, Frank Frizelle, Walter R. Frontera, Karen Geboes, Hugh L. Giddings, Chris Gillespie, Chelsia Gillis, Olivier Gléhen, Varsha Gorey, Catherine L. Granger, David Greenfield, Ben Griffiths, Chloe Grimmett, Claire Hackett, Travis Hall, Julie Hallet, Craig Harris, Sophie Hatcher, Lizza Hendriks, Mendy Hermans, C Ilyas, Hilmy Ismail, John T. Jenkins, Wilson Jiang, Charlotte Johnstone, Andreas Karakatsanis, Sascha Karunaratne, Simarjit Kaur, Michael P. Kelly, Joost M. Klaase, Dorian Kršul, Scott Leslie, Jenelle Loeliger, Marie‐Louise Lydrup, Andrea B. Maier, Piotr Major, Preet G. S. Makker, Christopher R. Mantyh, Stuart A. McCluskey, Laura W. McGarrity
Abstract
BACKGROUND: Recently, the number of prehabilitation trials has increased significantly. The identification of key research priorities is vital in guiding future research directions. Thus, the aim of this collaborative study was to define key research priorities in prehabilitation for patients undergoing cancer surgery. METHODS: The Delphi methodology was implemented over three rounds of surveys distributed to prehabilitation experts from across multiple specialties, tumour streams and countries via a secure online platform. In the first round, participants were asked to provide baseline demographics and to identify five top prehabilitation research priorities. In successive rounds, participants were asked to rank research priorities on a 5-point Likert scale. Consensus was considered if > 70% of participants indicated agreement on each research priority. RESULTS: A total of 165 prehabilitation experts participated, including medical doctors, physiotherapists, dieticians, nurses, and academics across four continents. The first round identified 446 research priorities, collated within 75 unique research questions. Over two successive rounds, a list of 10 research priorities reached international consensus of importance. These included the efficacy of prehabilitation on varied postoperative outcomes, benefit to specific patient groups, ideal programme composition, cost efficacy, enhancing compliance and adherence, effect during neoadjuvant therapies, and modes of delivery. CONCLUSIONS: This collaborative international study identified the top 10 research priorities in prehabilitation for patients undergoing cancer surgery. The identified priorities inform research strategies, provide future directions for prehabilitation research, support resource allocation and enhance the prehabilitation evidence base in cancer patients undergoing surgery.