ArticleBJA open2026
Home-based, virtually supported multimodal prehabilitation compared with usual care prior to major surgery: a multicentre, pragmatic pilot randomised trial.
Article in BJA open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06042491 (The STRIVE Before Surgery Pilot Trial), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The STRIVE Before Surgery Pilot Trial: a Vanguard Pragmatic Multicenter Randomized Trial of Structured TRaining to Improve Fitness in a Virtual Environment (STRIVE) Before Surgery
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: A pragmatic, multicentre randomised trial of virtually supported, home-based prehabilitation is required to evaluate effectiveness in generalisable settings; however, feasibility is unknown. Methods: This was a pragmatic, parallel-arm, multicentre internal pilot randomised controlled trial. Adults aged 18 years or older preparing for planned, inpatient non-cardiac, non-orthopaedic surgery were recruited from surgeons' offices at five Canadian centres (30 January to 11 July 2024). Participants were randomised to a virtually supported home-based prehabilitation programme (exercise, protein supplementation, psychosocial support) delivered by trained coaches using a theory-based approach, or to usual care. Feasibility outcomes were recruitment (target >6 participants/centre/month), adherence (>75%), and outcome completeness (>90%). Barriers and facilitators were assessed using a validated Theoretical Domains Framework (TDF) survey. Cluster analyses explored patterns of TDF responses and associations with adherence. Results: We randomised 144/154 eligible participants (93.5%; recruitment rate: 8.4, standard deviation [sd] 4.4 participants/center/month). The mean participant age was 62 (sd 12, range 28-85). Trial-level median adherence was 95% (inter-quartile range 73-100), and 57 (78.5%) participants achieved >75% adherence. Patient-reported outcomes were complete for 137 (95.1%) participants at 30 days, 136 (94.4%) at 90 days, and 129 (89.5%) at 365 days after operation. Participants identified beliefs about consequences and capabilities, intentions, and social roles as facilitators. Environmental context and emotions were barriers. Participants' TDF response profiles clustered in three groups. Cluster membership was strongly associated with adherence ( Conclusions: A pragmatic, multicentre trial of virtually supported home-based multimodal prehabilitation is feasible. Findings support progression to a fully powered trial. Observed associations between perceived barriers, facilitators, and adherence should be validated. Trial registration: ClinicalTrials.gov NCT06042491.
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