A review of the evidence for the effectiveness of digital delivery of cancer prehabilitation
Evidence Overview
Background
- Prehabilitation programmes form an important part of preparing patients for their cancer treatments; helping to optimise outcomes and quality of life and minimise the side effects of treatment. Prehabilitation should be delivered as set out in the Key Principles – Prehabilitation for Scotland.
- There is insufficient published evidence or local evaluation data to make any conclusions about the clinical or cost-effectiveness of digitally delivered prehabilitation programmes for patients with cancer.
- Projects designed to evaluate digital prehabilitation for patients with cancer should consider the SHTG Evidence Framework to guide the collection of relevant data in order to inform decision making on the use of digital prehabilitation programmes.
- The published evidence on the effectiveness of digital prehabilitation programmes for patients with cancer is of low quantity and quality.
- One UK prospective observational study (n=139) identified significant improvements in emotional wellbeing and anxiety between baseline and 12 weeks postoperatively.The study found that it is feasible to recruit patients to digital prehabilitation programmes. A small focus group of patients (n=7) did not raise a prior lack of digital ability and literacy as barriers to participation.
- A Belgian based cohort study (n=23) of a single prehabilitation intervention in patients with oesophagogastric cancer concluded that a digital prehabilitation is feasible, showing high retention rates (96 %) and high patient satisfaction. In this small group of patients, digital prehabilitation led to significant improvements in emotional wellbeing, with no differences found in other patient reported outcome measures.
- Digital prehabilitation programmes are acceptable to patients but providers remain concerned about digital inclusion relating to socioeconomic deprivation and lower digital literacy.
- No studies were identified that assessed the cost effectiveness of digital prehabilitation. No data were available from health boards in Scotland. The absence of evidence and local data meant that no cost effectiveness analysis or budget impact modelling could be performed.
- Further research is required to inform the use of digital prehabilitation programmes in NHS Scotland. The SHTG Evidence Framework should be used to help inform data collection, for example:
- prespecified patient and service outcome data should be collected, alongside the costs of the technology
- patient and clinical views should be collected on the suitability of digitally delivered programmes (especially compared with non-digital prehabilitation).
Assessment
Cancer
23 April 2024
Scottish Government
