Cost-effectiveness of a technology-supported multimodal prehabilitation program in moderate-to-high risk patients undergoing lung cancer resection: randomized controlled trial protocol.

Xavier Alsina-Restoy, Graciela Martinez-Palli, Josep Roca, Maria Jose Arguis, Antonio López, Rudith Guzmán, Barbara Romano-Andrioni, Manuel Lopez-Baamonde, Betina Campero, Anael Barberan-Garcia, Mar Montané-Muntané, Laura González-Vallespí, Monique Messaggi-Sartor, Marc Boada, Jorge Moisés-Lafuente, David Sánchez-Lorente, Ricard Navarro-Ripoll

Journal: BMC health services research 2020;20(1):207

PMID: 32164687

Abstract

BACKGROUND

Multimodal prehabilitation is a preoperative intervention with the objective to enhance cancer patients' functional status which has been showed to reduce both postoperative morbidity and hospital length of stay in digestive oncologic surgery. However, in lung cancer surgery patients further studies with higher methodological quality are needed to clarify the benefits of prehabilitation. The main aim of the current protocol is to evaluate the cost-effectiveness of a multimodal prehabilitation program supported by information and communication technologies in moderate-to-high risk lung cancer patients undergoing thoracic surgery.

METHODS

A Quadruple Aim approach will be adopted, assessing the prehabilitation program at the following levels: i) Patients' and professionals' experience outcomes (by means of standardized questionnaires, focus groups and structured interviews); ii) Population health-based outcomes (e.g. hospital length of stay, number and severity of postoperative complications, peak oxygen uptake and levels of systemic inflammation); and, iii) Healthcare costs.

DISCUSSION

This study protocol should contribute not only to increase the scientific basis on prehabilitation but also to detect the main factors modulating service adoption.

TRIAL REGISTRATION

NCT04052100 (August 9, 2019).

Address: Respiratory Medicine Department, Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain. [email protected].; August Pi i Sunyer Biomedical Research Institute - IDIBAPS, University of Barcelona (UB), Barcelona, Spain. [email protected].; Biomedical Networking Research Centre on Respiratory Diseases (CIBERES), Barcelona, Spain. [email protected].; Anaesthesia and Intensive Care Department, Hospital Clínic de Barcelona, Barcelona, Spain.; Thoracic Surgery Department, Hospital Clínic de Barcelona, Barcelona, Spain.; Respiratory Medicine Department, Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain.; August Pi i Sunyer Biomedical Research Institute - IDIBAPS, University of Barcelona (UB), Barcelona, Spain.; Clinical Psychology Department, Hospital Clínic de Barcelona, Barcelona, Spain.; Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain.; Biomedical Networking Research Centre on Respiratory Diseases (CIBERES), Barcelona, Spain.
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