Digital Support to Multimodal Community-Based Prehabilitation: Looking for Optimization of Health Value Generation

Frontiers in Oncology

Graciela Martínez-Pallí¹  Anael Barberan-Garcia²  Isaac Cano²  Bart C. Bongers³  Steffen Seyfried⁷  Thomas Ganslandt⁷  Florian Herrle⁷ 

[1] Anesthesiology Medicine Department, Hospital Clínic de Barcelona, Barcelona, Spain;Departemenr of Medicine, Universitat de Barcelona, Barcelona, Spain;Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands;Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands;Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain;Prehabilitation Unit, Hospital Clínic de Barcelona, Barcelona, Spain;University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany;

关键词: exercise training and nutrition counseling;    psychological well-being;    physical activity;    technology – ICT;    eHealth;    prehabilitation;   

DOI  :  10.3389/fonc.2021.662013

来源: DOAJ

【 摘 要 】

Prehabilitation has shown its potential for most intra-cavity surgery patients on enhancing preoperative functional capacity and postoperative outcomes. However, its large-scale implementation is limited by several constrictions, such as: i) unsolved practicalities of the service workflow, ii) challenges associated to change management in collaborative care; iii) insufficient access to prehabilitation; iv) relevant percentage of program drop-outs; v) need for program personalization; and, vi) economical sustainability. Transferability of prehabilitation programs from the hospital setting to the community would potentially provide a new scenario with greater accessibility, as well as offer an opportunity to effectively address the aforementioned issues and, thus, optimize healthcare value generation. A core aspect to take into account for an optimal management of prehabilitation programs is to use proper technological tools enabling: i) customizable and interoperable integrated care pathways facilitating personalization of the service and effective engagement among stakeholders; ii) remote monitoring (i.e. physical activity, physiological signs and patient-reported outcomes and experience measures) to support patient adherence to the program and empowerment for self-management; and, iii) use of health risk assessment supporting decision making for personalized service selection. The current manuscript details a proposal to bring digital innovation to community-based prehabilitation programs. Moreover, this approach has the potential to be adopted by programs supporting long-term management of cancer patients, chronic patients and prevention of multimorbidity in subjects at risk.

【 授权许可】

Unknown