Study Examines the Barriers to Patient Participation and Adherence to Prehabilitation Programs

Clemons J, Zhou Z, Hoy SA, et al. No Thanks and Not for Me: A Qualitative Study of Barriers to Prehabilitation Participation. Surgery. 2024; in press.

Prehabilitation programs have been shown to improve postoperative recovery and long-term outcomes, but patients often decline participation in these programs or have poor adherence to program components.

This article reported outcomes of a study that sought to identify why patients decline participation or have poor adherence. The authors conducted structured interviews of 11 patients who were scheduled to undergo major abdominal surgical procedures.

Identification of seven barriers to participation and adherence to prehabilitation resulted from the interviews. Barriers included poorly timed or conducted recruitment, patient misconceptions of dietary requirements, competing priorities, lack of family alignment, belief that prehabilitation would not be helpful, concerns over specific program requirements, and belief that prehabilitation would be helpful to others but not themselves.

Pathways for improvement of participation and adherence were identified and included improved communication, customization of program components, and reframing the program as feasible with increased emphasis on ease of completion.