Table 1

Summary of prehabilitation interventions and what was offered to participants attending supervised sessions

Perioperative risk factorSummary of interventionSummary of what was offered to participants attending supervised sessions (n=54)
Physical inactivity/low physical fitnessSupervised aerobic and resistance exercise training (one or two sessions per week) and unsupervised exercise and physical activity (as agreed with intervention facilitator). Patients with an increased risk of postoperative pulmonary complications also do inspiratory muscle training. See online supplementary table 3 for further detail.All 54 participants had exercise as an agreed intervention; 17 (31%) also undertook inspiratory muscle training
SmokingBrief advice on smoking cessation from project manager with onward referral to stop smoking services providing combined structured counselling and nicotine replacement therapy.Seven participants were smokers at baseline
Two agreed to referral, two self-referred, three attempted to stop independently
UnderweightFortisip Compact Protein high energy (2.4 kcal/mL), high protein (18 g/bottle) nutritional supplement; 2×125 mL bottle each day (2.4 kcal/mL)Two underweight participants received nutritional supplements
ObeseBrief advice on diet from project manager emphasising healthy eating with onward referral to local specialist weight management service.Three participants with obesity received brief advice from the project manager; one was referred to the weight management service
FrailtyNotification of general practitioner (GP) and secondary care teams by project managerOne participant was frail at baseline—their GP and secondary care teams were notified
Excessive alcoholBrief advice on alcohol reduction from project manager to reduce intake below 14 units weekly. Onward referral to specialist alcohol services if features of dependence present.25 (46%) participants were alcohol drinkers at baseline
11 drinkers received brief advice from the project manager, 1 was referred to the alcohol reduction service
AnaemiaRapid access to preoperative anaemia pathway (with provision of intravenous iron),or referral for management via GP dependent on severity and preoperative timeframes.Seven participants were anaemic at baseline
Five participants received intravenous iron via the preassessment pathway, two were referred to their GP
Obstructive sleep apnoeaExpedited home-based diagnostic sleep test to identify obstructive sleep apnoea following identification of increased risk via initial questionnaire screeningThree participants were deemed high risk for obstructive sleep apnoea; following further evaluation, one initiated continuous positive airway pressure therapy
Anxiety/depressionReferral for mindfulness training or psychological counsellingNine participants had elevated anxiety or depression scores (HADS>7) at baseline, six had raised anxiety and depression scores
Five participants were offered mindfulness training, one was referred to counselling
  • HADS, Hospital Anxiety and Depression Scale.