IMproving the PReoperative StatuS of patients undergoing major surgery

Rationale: The eHealth application ‘Beter Voorbereid’ is an eHealth application that uses a set of questions to map a patient’s lifestyle risk factors for delayed postoperative recovery in patients undergoing major surgery. Based on the lifestyle risk profile of the patient, a tailored preoperative lifestyle advise is provided. Furthermore, the patient can use the eHealth application to make an appointment with a local physiotherapist to improve the physical fitness of the patient under supervision. The eHealth application can be displayed on a smartphone and tablet. The application is offered to the patient during his/her visit to the preoperative outpatient clinic. It is currently unknown whether the use of an app to advice patients in improving their pre-operative lifestyle is more beneficial than usual care in enhancing functional recovery after surgery.

Objective: To investigate whether use of the ‘Beter Voorbereid’ application is associated with improved functional recovery after surgery when compared to control patients

Study design: A multicenter randomized controlled trial (RCT) will be conducted.

Intervention: Use of an eHealth application for prehabilitation of surgical patients in the preoperative period. The intervention group is compared to control subjects receiving usual care.

Main study outcomes: Primary outcome is the course of functional recovery after surgery. Secondary outcomes are functional recovery, in-hospital physical symptoms, physical functioning and psychological functioning, social participation, patient satisfaction, global health, lifestyle risk factors and peri-operative factors.

The use of the ‘Beter Voorbereid’ eHealth application modifies risk behaviour and improves the patients functional capacity which leads to a better functional recovery after surgery.

Five time points, at baseline and 1 week, 3 weeks, 6 weeks and 12 weeks after hospital discharge.

The eHealth application is a mobile application, which participants have to download to their device. The app can be used on smartphones and tablets.
Participants receive support in optimizing their health and lifestyle in the peri-operative period. Participants with an indication to enhance preoperative physical fitness have the possibility to enhance their fitness under supervision of a specialized local physiotherapist, who can be found via the app. The total package of advices may include smoking cessation, lowering of alcohol intake, nutritional advices and exercise advices (physical activity increase and/or muscle strengthening). The advices consists of specific tasks the patient can perform based on the personal profile of the patient. Advices are provided in the pre-operative period, as well as in the direct post-operative period. The participant receives feedback on the tasks performed using the application.