{
  "abstract": "Introduction Prehabilitation is a promising preoperative intervention to improve patient recovery after surgery. Virtually delivered, home-based programmes represent the most efficient model for prehabilitation delivery. However, virtually delivered prehabilitation interventions remain understudied. This manuscript describes the protocol for a pilot randomised controlled trial (RCT) of a virtually monitored, home-based prehabilitation intervention.Methods and analysis We will conduct a pilot RCT comparing the standard of care to a virtually monitored home-based prehabilitation programme in adults undergoing major elective intrathoracic, intra-abdominal or orthopaedic surgery. Outcome assessors will be blinded to treatment allocation. The intervention consists of 3–4 weeks of a multimodal (exercise, nutrition and psychosocial support) prehabilitation programme supported through a mobile application already in use at the Kingston Health Sciences Centre. The primary feasibility outcomes and their targets are: (1) monthly recruitment rate of >20 participants across all centres and (2) mean intervention adherence of >80%. A sample of 120 participants will be adequate to estimate recruitment and adherence rates with acceptable precision. The secondary outcomes include comparisons of complications, mortality, new-onset disability, length of stay, readmission, quality of life, nutritional status and functional capacity between intervention arms. Secondary outcomes will be collected prior to randomisation, 2 days before surgery and 30 days after surgery.Ethics and dissemination Ethical approval has been granted by Clinical Trials Ontario (Project ID: 5495). Results will be disseminated through presentations at scientific conferences, peer-reviewed publications and engagement with traditional and social media.Trial registration number ClinicalTrials.gov ( NCT07590141).",
  "authors": [
    {
      "affiliations": [
        "School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada"
      ],
      "name": "Joshua J Aube"
    },
    {
      "affiliations": [
        "School of Medicine, Queen’s University, Kingston, Ontario, Canada"
      ],
      "name": "Dhruvrajsinh Rathod"
    },
    {
      "affiliations": [
        "Anaesthesiology and Pain Medicine, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"
      ],
      "name": "Danial I McIsaac"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Perioperative Medicine, Queen’s University, Kingston, Ontario, Canada"
      ],
      "name": "Joel L Parlow"
    },
    {
      "affiliations": [
        "Department of General Surgery, Queen’s University, Kingston, Ontario, Canada"
      ],
      "name": "Ameer Farooq"
    },
    {
      "affiliations": [
        "Department of Surgery, McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Tyler McKechnie"
    },
    {
      "affiliations": [
        "Department of Surgery, McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Cagla Ekicioglu"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Perioperative Medicine, Queen’s University, Kingston, Ontario, Canada"
      ],
      "name": "Deborah DuMerton"
    },
    {
      "affiliations": [
        "School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada"
      ],
      "name": "Brendon J Gurd"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Perioperative Medicine, Queen’s University, Kingston, Ontario, Canada"
      ],
      "name": "Jordan Leitch"
    }
  ],
  "title": "PRIME pilot trial: a protocol for a multicentre pilot randomised controlled trial of PRehabilitation In advance of Major Elective surgery (PRIME)",
  "uid": "ff558ec9-a644-5330-b164-61cc79298191"
}