JMIR Publications

ABSTRACT

Background:

The efficacy of cancer prehabilitation programs is supported by international reviews and meta-analyses. Technology has been deployed in cancer prehabilitation to address challenges such as access or limited resources. This study evaluated the feasibility, user acceptance, safety, and program outcomes of a newly developed mobile application for cancer prehabilitation. The app integrates with Singapore's existing healthcare mobile app, Health Buddy, and provides instructional videos for prescribed exercises.

Objective:

The objectives of this study were to investigate the feasibility, user experience, safety, and outcomes of a mobile app for cancer prehabilitation within a hospital-associated home-based multimodal cancer prehabilitation program.

Methods:

This was a retrospective analysis involving patients enrolled in the Cancer Prehabilitation program from September 1st, 2022, to March 30th, 2023. Patients enrolled in the prehabilitation program (n=66) were categorized into two groups: those prescribed the app (n=43) and those who were not (n=23). There was further subgroup analysis of those who were prescribed: app-users (n=25) versus those who were not (n=18). Demographics, Fried Frailty Phenotype, prehabilitation duration, app use, compliance to the program and functional outcome measures (6MWT, STS, TUGT, HADS) were collected. Baseline characteristics and pre-operative outcomes were compared between the groups. User satisfaction was assessed through surveys among app users (n=25).

Results:

Among 66 patients, 43 (65%) were prescribed the app of which 25 (58.1%) were users. No significant differences in pre-operative functional improvements were observed between app users and non-users, or between those prescribed and not prescribed the app. However, high compliance rates (80%) were observed among app users. Patient satisfaction with the app was high (>90%), with positive feedback on ease of use and technical reliability . Baseline measures revealed significantly lower functional scores and higher mean frailty scores in the non-prescribed group.

Conclusions:

This preliminary study demonstrates the acceptability, feasibility and safety of Singapore's first smartphone app for exercise prescription in cancer prehabilitation. Lower baseline functional outcome measures and a higher mean frailty score in the unprescribed group has implications in the selection process and patient participation. Further studies should include strategies to enhance patients’ readiness for technology, sustainability as well as effectiveness in older patients.