Feasibility of a home-based perianesthesia nurse-led remote multimodal prehabilitation program using smartphone applications for older adults undergoing surgery.

purposeTo assess the feasibility of a home-based perianesthesia nurse-led remote multimodal prehabilitation program with smartphone applications for older patients undergoing surgery.

methodsIn this single-arm, prospective interventional study, patients aged ≥ 65 years scheduled for surgery under general anesthesia at a Japanese tertiary hospital were enrolled. Eligible patients were those undergoing various surgical procedures, able to use a smartphone, and with at least 14 days between the surgical decision and the operation. Exclusion criteria were based on the discontinuation criteria for cancer rehabilitation. The intervention was entirely home-based and consisted of nutritional therapy, exercise therapy, and cognitive training. The primary outcome was the feasibility of a remotely implemented multimodal prehabilitation program, assessed by participation, adherence, and completion rates. Secondary outcomes included the incidence of postoperative complications and changes in disability during the perioperative period.

resultsAmong the 100 eligible patients, the participation rate was 50% (50/100), with a 92% completion rate (46/50). Adherence rates were 67.4% for nutritional therapy; 19.6% for achieving 5000 steps per day and 56.5% for achieving 2000 steps per day in exercise therapy; and 78.3% for squats, 78.3% for heel raises, and 60.9% for front lunges in resistance training. In cognitive training, 2.1% engaged in training games for at least 30 min per day, whereas 34.8% did so for at least 15 min per day. No adverse events occurred.

conclusionThis home-based perianesthesia nurse-led remote multimodal prehabilitation program with smartphone applications was safely implemented for older patients under the leadership of perianesthesia nurses.