Background: Patient involvement in research enhances its relevance and usefulness to its target beneficiaries. Recently the number of cancer prehabilitation trials has increased significantly but their development has not incorporated patient or carer priorities. Thus, the aim of this study was to compare the top research priorities of cancer patients and/or their carers with those of prehabilitation experts.
Methods: This cross-sectional study surveyed cancer patients and/or their carers at a major tertiary hospital in Sydney, Australia between March 2023 and June 2023. Patients were eligible if aged 18 years or over and in the postoperative period following cardiothoracic, upper gastrointestinal, or colorectal cancer surgery. Patients and carers were provided a list of 12 top prehabilitation research priorities that recently reached consensus of highest importance by an international-level, multidisciplinary group of prehabilitation experts. Patients and carers were asked to rate the importance of each research priority using a 5 item Likert scale (1=very high research priority; 5=very low research priority). Differences in research priorities between experts, patients and carers were determined by chi-squared test or Fisher’s Exact test.
Results: A total of 58 patients and 31 carers have participated to date. The top three research priorities that have reached consensus of highest importance (>70% rated as “high or very high research priority”) by patients were prehabilitation during neoadjuvant therapies (81%), the effect of prehabilitation on surgical outcomes (79%) and the effect of prehabilitation on patient reported outcomes (79%). Four research priorities achieved mutual agreement of highest importance by experts, patients and carers. These were the effect of prehabilitation on surgical outcomes (96% vs 79% vs 84%), optimal composition of prehabilitation programs (88% vs 72% vs 84%), the effect of prehabilitation on patient reported outcomes (79% vs 79% vs 87%), and the effect of prehabilitation on functional outcomes (81% vs 78% vs 87%). Priorities that reached consensus of highest importance by experts but not patients included identifying populations most likely to benefit from prehabilitation (90% vs 66% vs 77%) and defining prehabilitation core outcome measures (86% vs 62% vs 71%).
Conclusion: Four research priorities achieved mutual agreement of high importance by experts, patients and carers. This information informs the development of future prehabilitation trials and facilitates meaningful resource allocation to enhance the evidence base for cancer patients undergoing surgery.