Do Text Message Reminders Increase Preoperative Exercise in Obesity Surgery Candidates?

Study Overview
=================
Brief Summary
-----------------
Preoperative exercise has been shown to improve physiological and functional capacity in patients undergoing abdominal surgery to prepare them for the stress of surgery. Patients undergoing bariatric surgery are advised to partake in regular preoperative exercise. In the setting of bariatric surgery, as well as preparing patients for the stress of surgery, it is also thought to increase the likelihood that they will exercise postoperatively. However, compliance to this advice is extremely low. Text-message interventions have been shown to improve compliance to other lifestyle interventions. The investigators will compare the rate of compliance to preoperative exercise prior to bariatric surgery in patients who receive a daily text message to those who do not. The investigators will also compare weight loss.

Official Title
-----------------
Text Messaging to Improve Adherence to Prehabilitation in Patients Undergoing Bariatric Surgery: a Randomised Controlled Trial

Conditions
-----------------
Perioperative Care, Bariatric Surgery, Obesity

Intervention / Treatment
-----------------
* Behavioral: Daily text message reminders


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients having laparoscopic sleeve gastrectomy at Manukau Surgery Centre Operation used primarily for the treatment of morbid obesity Exclusion Criteria: Operation not performed at Manukau Surgery Centre Patient does not have a mobile phone which can receive text messages

Ages Eligible for Study
-----------------
Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Text message group<br>Patients randomised to this group will receive daily text message reminders used to motivate them to exercise in the preoperative period. They will also receive an exercise information sheet to complement the text messages. | Behavioral: Daily text message reminders<br>* Daily text message reminders to motivate patients to exercise in conjunction with an exercise information sheet.<br>|
| No Intervention: No text message group<br>Patients randomised to this group will receive standardised exercise advice but will not receive the text message reminders or the exercise information sheet. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of patients partaking in the minimum recommended amount of weekly physical activity | >450 METmins per week of physical activity as measured by the internationally and locally validated IPAQ questionnaire. | 6 weeks post recruitment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative Physical Activity | Quantity of physical acitivty will be measured as METmins per week as measured by the IPAQ questionnaire | 6 weeks postoperatively | 
| Functional capacity | Measured using the 6 minute walk test | Baseline and 6 weeks post recuitment (preoperatively) | 
| Length of Hospital Stay | Total number of days spent in hospital following their operation | As assessed at day of discharge | 
| Short term weight loss | Postoperative weight loss as measured by percentage of excess weight loss | Out to 6 months postoperatively | 
| Perioperative complications | Prospectively recorded postoperative complications graded according the Clavien-Dindo classification system | Out to 30 days postoperatively |