Patients’ and carers’ views on research priorities in prehabilitation for cancer surgery
Authors: Vu Jennifer , Koh Cherry , Solomon Michael , Brown Kilian , Karunaratne Sascha , Cole Ruby , Smith Phillippa , Raichurkar Pratik , Denehy Linda , Riedel Bernhard ,   Prehabilitation Expert Collaborative, Allen Jonathan , Ancog Kevin , Angenete Eva , Ansari Nabila , Ausania Fabio , Beaumont Anna , Beilstein Christian , Berrevoet Frederik , Boden Ianthe , Bongers Bert , Bostock Kimberley , Bothe Janine , Brandstrup Birgitte , Brennan Louise , Burden Sorrel , Burgess Crystal , Burns Elaine , Carli Francesco , Cavalheri Vinicius , Ceelen Wim , Chesney Tyler , Clark David , Clifford Kari , Cole Kelcie , Collyer Thomas , Copeland Rob , Croner Roland , Crowe Jess , Daniels Ian , Danjoux Gerard , Davis June , Davis Caitlin , de Klerk Mayke , Decorte Tina , Dekker Jan Willem , Denys Andreas , Desender Liesbeth , Dries Pieter , Dunne Declan , Edbrooke Lara , Edgar Linda , Eissa Sabry , Engel Dominique , Ephraums James , Evans Martyn , Farrell Rhonda , Finch Alice , Fleury Aisling , Forget Patrice , Francis Nader , Frizelle Frank , Frontera Walter , Geboes Karen , Giddings Hugh , Gillespie Chris , Gillis Chelsia , Glehen Olivier , Gorey Varsha , Granger Catherine , Greenfield Diana , Griffiths Ben , Grimmett Chloe , Hackett Claire , Hall Travis , Hallet Julie , Harris Craig , Hatcher Sophie , Hendriks Lizza , Hermans Mendy , Ilyas Carl , Ismail Hilmy , Jenkins John , Jiang Wilson , Johnstone Charlotte , Karakatsanis Andreas , Kaur Simarjit , Kelly Michael , Klaase Joost , Kršul Dorian , Leslie Scott , Loeliger Jenelle , Lydrup Marie-Louise , Maier Andrea , Major Piotr , Makker Preet , Mantyh Christopher , McCluskey Stuart , McGarrity Laura , Moloney Jayson , Montroni Isacco , Moran Brendan , Morris Paul , Moug Susan , Ms Rajeswari , Murdoch Sandra , Myers Anna , Ng Kheng-Seong , Nilsson Per J. , Noordzij Peter , O’Connor Mike , Pellino Gianluca , Philp Shannon , Pocard Marc , Puthucheary Zudin , Putrus Emma , Quyn Aaron , Read Thomas , Ricketts William , Rutten Harm , Sabajo Charissa , Salihi Rawand , Sammour Tarik , Sandroussi Charbel , Mina Daniel Santa , Saric Stefan , Sebio Raquel , Seyfi Doruk , Singh Favil , Slooter Gerrit , Smart Neil , Spencer Lissa , Sutton Paul , Tan Hao Ern , Cate David Ten , Turna Akif , Van Daele Elke , van den Berg Adinda , van Kessel Charlotte , van Ramshorst Gabrielle , Verdaasdonk Emiel , Wakeman Chris , West Malcolm , Wheeler James , Wijeysundera Duminda , Yano Hideaki , Steffens Daniel 
Published: May 2024

Abstract
Introduction
The views of patients and carers are important for the development of research priorities. This study aimed to determine and compare the top research priorities of cancer patients and carers with those of multidisciplinary clinicians with expertise in prehabilitation.

Materials and methods
This cross-sectional study surveyed patients recovering from cancer surgery at a major tertiary hospital in Sydney, Australia, and/or their carers between March and July 2023. Consenting patients and carers were provided a list of research priorities according to clinicians with expertise in prehabilitation, as determined in a recent International Delphi study. Participants were asked to rate the importance of each research priority using a 5-item Likert scale (ranging from 1 = very high research priority to 5 = very low research priority).

Results
A total of 101 patients and 50 carers participated in this study. Four areas were identified as research priorities, achieving consensus of highest importance (> 70% rated as “high” or “very high” priority) by patients, carers, and clinical experts. These were “optimal composition of prehabilitation programs” (77% vs. 82% vs. 88%), “effect of prehabilitation on surgical outcomes” (85% vs. 90% vs. 95%), “effect of prehabilitation on functional outcomes” (83% vs. 86% vs. 79%), and “effect of prehabilitation on patient reported outcomes” (78% vs. 84% vs. 79%). Priorities that did not reach consensus of high importance by patients despite reaching consensus of highest importance by experts included “identifying populations most likely to benefit from prehabilitation” (70% vs. 76% vs. 90%) and “defining prehabilitation core outcome measures” (66% vs. 74% vs. 87%). “Prehabilitation during neoadjuvant therapies” reached consensus of high importance by patients but not by experts or carers (81% vs. 68% vs. 69%).

Conclusion
This study delineated the primary prehabilitation research priorities as determined by patients and carers, against those previously identified by clinicians with expertise in prehabilitation. It is recommended that subsequent high-quality research and resource allocation be directed towards these highlighted areas of importance.