• Anael Barberan-Garcia, Ricard Navarro-Ripoll, David Sánchez-Lorente, Jorge Moisés-Lafuente, Marc Boada, Monique Messaggi-Sartor, Laura González-Vallespí, Mar Montané-Muntané, Xavier Alsina-Restoy, Betina Campero, Manuel Lopez-Baamonde, Barbara Romano-Andrioni, Rudith Guzmán, Antonio López, Maria Jose Arguis, Josep Roca, and Graciela Martinez-Palli.
• Respiratory Medicine Department, Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain. anbarber@clinic.cat.
• Bmc Health Serv Res. 2020 Mar 12; 20 (1): 207.

BackgroundMultimodal prehabilitation is a preoperative intervention with the objective to enhance cancer patients' functional status which has been showed to reduce both postoperative morbidity and hospital length of stay in digestive oncologic surgery. However, in lung cancer surgery patients further studies with higher methodological quality are needed to clarify the benefits of prehabilitation. The main aim of the current protocol is to evaluate the cost-effectiveness of a multimodal prehabilitation program supported by information and communication technologies in moderate-to-high risk lung cancer patients undergoing thoracic surgery.MethodsA Quadruple Aim approach will be adopted, assessing the prehabilitation program at the following levels: i) Patients' and professionals' experience outcomes (by means of standardized questionnaires, focus groups and structured interviews); ii) Population health-based outcomes (e.g. hospital length of stay, number and severity of postoperative complications, peak oxygen uptake and levels of systemic inflammation); and, iii) Healthcare costs.DiscussionThis study protocol should contribute not only to increase the scientific basis on prehabilitation but also to detect the main factors modulating service adoption.Trial RegistrationNCT04052100 (August 9, 2019).

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