A new pilot study is testing whether patients can prepare for major surgery at home using a mobile app instead of traveling to hospitals. The PRIME trial will evaluate a 3-4 week program combining exercise, nutrition guidance, and mental health support delivered through an app. Gram Research analysis shows this 120-patient pilot aims to recruit over 20 patients monthly and achieve 80% program completion—key indicators that home-based prehabilitation is practical and worth studying further for improving surgical recovery.
Researchers are testing a new way to help people prepare for major surgery using their phones and home exercises. The PRIME pilot trial is studying whether a 3-4 week program combining exercise, better nutrition, and mental health support—delivered through a mobile app—helps patients recover faster after surgery. According to Gram Research analysis, this study of 120 patients will test whether this home-based approach is practical and whether patients actually stick with it. If successful, this could change how hospitals prepare patients for surgery by making preparation easier and more accessible from home.
Key Statistics
The PRIME pilot randomized controlled trial of 120 patients, published in BMJ Open in 2026, is testing whether a home-based prehabilitation program delivered through a mobile app can recruit more than 20 patients per month across multiple Canadian hospitals.
According to the PRIME protocol, the prehabilitation intervention targets mean adherence of greater than 80% over a 3-4 week period combining exercise, nutrition, and psychosocial support delivered virtually before major surgery.
The PRIME pilot trial will measure surgical outcomes including complications, hospital length of stay, readmission rates, and functional capacity at 30 days post-surgery to determine whether home-based prehabilitation improves recovery compared to standard care.
This 2026 pilot study of 120 adults undergoing major intrathoracic, intra-abdominal, or orthopedic surgery uses blinded outcome assessors and multi-center design to test the feasibility of virtually monitored, home-based prehabilitation before conducting a full-scale trial.
The Quick Take
- What they studied: Whether a home-based prehabilitation program delivered through a mobile app helps patients prepare better for major surgery and recover faster
- Who participated: 120 adults scheduled for major surgery (chest, abdominal, or bone/joint procedures) at Canadian hospitals, randomly assigned to either standard care or the new prehabilitation program
- Key finding: This is a pilot study testing whether the program can recruit more than 20 patients per month and whether patients complete at least 80% of the program—both signs that the approach is practical and worth studying further
- What it means for you: If this pilot succeeds, patients facing major surgery may soon be able to prepare at home using their phones instead of traveling to hospitals for preparation classes, potentially improving recovery and reducing complications
The Research Details
This is a pilot randomized controlled trial, which means researchers randomly assigned 120 patients to either receive standard surgical preparation or a new 3-4 week home-based prehabilitation program. The program includes three main components: guided exercises to build strength and endurance, nutrition advice to optimize eating before surgery, and mental health support to reduce anxiety and stress. Patients in the intervention group use a mobile app to access the program and receive monitoring from healthcare providers. Researchers will measure whether they can recruit enough patients and whether patients actually complete the program—these are the main goals of a pilot study. The study takes measurements before surgery, two days before the operation, and 30 days after surgery to track recovery.
Most prehabilitation programs require patients to visit hospitals in person, which can be inconvenient and expensive. This pilot tests whether delivering the program through a mobile app at home works just as well or better. If successful, it could make prehabilitation available to more patients and reduce barriers to preparation. The study design with blinded outcome assessors (meaning the people measuring results don’t know which group patients were in) helps ensure fair and unbiased results.
This is a well-designed pilot study with several strengths: it’s randomized (reducing bias), uses blinded outcome assessors, includes multiple hospitals (making results more generalizable), and measures both practical outcomes (recruitment and adherence) and clinical outcomes (complications, recovery). The study was approved by Clinical Trials Ontario and registered on ClinicalTrials.gov, indicating it meets high ethical and scientific standards. However, as a pilot study, it’s designed to test feasibility rather than prove effectiveness, so results should be viewed as preliminary.
What the Results Show
This is a protocol paper describing the planned study rather than reporting actual results. The primary goals are to determine whether researchers can recruit more than 20 patients per month across all participating hospitals and whether patients complete at least 80% of the prehabilitation program. These targets are important because they indicate whether the program is practical enough to study on a larger scale. If recruitment is slower or adherence is lower, researchers would need to modify the approach before conducting a full-scale trial. The study will also track secondary outcomes including surgical complications, hospital length of stay, readmission rates, quality of life, nutritional status, and physical function at 30 days after surgery.
Beyond recruitment and adherence, the study will examine whether patients in the prehabilitation group experience fewer complications after surgery, shorter hospital stays, fewer readmissions, better quality of life, improved nutritional status, and better physical function compared to the standard care group. These outcomes will help determine whether the home-based program actually improves recovery, not just whether it’s feasible to deliver.
Prehabilitation—preparing the body and mind before surgery—has shown promise in previous research for improving recovery and reducing complications. However, most existing studies focus on in-person programs at hospitals. This pilot is important because it tests a newer delivery method (virtual, home-based) that hasn’t been as thoroughly studied. If successful, it could expand access to prehabilitation for patients who can’t easily travel to hospitals or prefer to prepare at home.
As a pilot study, this research is designed to test feasibility rather than prove that the program works. The sample size of 120 is too small to draw firm conclusions about whether the program actually reduces complications or improves recovery—that would require a larger study. The study only follows patients for 30 days after surgery, so longer-term effects are unknown. Results may only apply to patients at the participating Canadian hospitals and may not reflect outcomes in other healthcare systems or populations.
The Bottom Line
This is a pilot study, so recommendations are preliminary. If the pilot succeeds in recruiting patients and achieving good adherence, the next step would be a larger trial to determine whether the program actually improves surgical outcomes. Patients considering major surgery should discuss prehabilitation options with their surgical team. Healthcare providers should monitor this research as a potential way to improve patient preparation and recovery.
This research is most relevant to: (1) patients scheduled for major chest, abdominal, or orthopedic surgery who want to optimize their recovery, (2) hospitals and surgical centers looking for innovative ways to prepare patients, (3) healthcare providers interested in virtual care delivery, and (4) researchers studying surgical outcomes and prehabilitation. Patients with severe mobility limitations or those without smartphone access may face barriers to participating in this type of program.
This is a pilot study, so results are expected in 2026-2027. If the pilot is successful, a larger trial would likely take 2-3 additional years. Patients shouldn’t expect widespread availability of this program until after the full trial is completed and results are published, likely 2028 or later.
Frequently Asked Questions
What is prehabilitation and why does it matter before surgery?
Prehabilitation is preparing your body and mind before surgery through exercise, nutrition, and stress management. Research shows it can reduce complications, shorten hospital stays, and improve recovery. This pilot tests whether doing it at home via an app works as well as in-person programs.
How long do I need to do the prehabilitation program before surgery?
The PRIME program lasts 3-4 weeks before surgery. It includes daily exercise (20-30 minutes), nutrition guidance, and mental health support delivered through a mobile app. The goal is to build strength and prepare mentally for the operation.
Will this home-based prehabilitation program reduce my surgery complications?
This pilot study tests whether the program is practical to deliver, not whether it reduces complications. A larger trial would be needed to prove effectiveness. However, previous research suggests prehabilitation generally improves surgical outcomes.
Who should consider doing prehabilitation before major surgery?
Anyone scheduled for major chest, abdominal, or orthopedic surgery may benefit from prehabilitation. Talk to your surgical team about whether it’s appropriate for you. Those without smartphone access or severe mobility limitations may face barriers to this virtual program.
When will this prehabilitation program be available at my hospital?
Results from this pilot study are expected in 2026-2027. If successful, a larger trial would follow, taking 2-3 more years. Widespread availability likely won’t occur until 2028 or later, pending full trial results and hospital adoption.
Want to Apply This Research?
- Track daily completion of prehabilitation exercises (target: 5-6 days per week), nutrition milestones (protein intake, hydration), and mood/anxiety levels using a simple daily check-in. Measure baseline physical function (like how far you can walk or how many stairs you can climb) and repeat at 2 weeks and 1 week before surgery to see improvement.
- Users should commit to 20-30 minutes of guided exercise daily, follow personalized nutrition recommendations, and complete brief mental health check-ins. The app can send reminders, track progress with visual charts, and allow secure messaging with the healthcare team for questions or concerns.
- Set weekly goals for exercise completion and nutrition adherence. Use the app to track physical improvements (increased strength, better endurance) and mental health markers (reduced anxiety, better sleep). Share progress reports with your surgical team at pre-operative appointments to adjust the program if needed.
This article describes a pilot study protocol and does not report final results. Prehabilitation should only be undertaken under medical supervision and with approval from your surgical team. This information is educational and should not replace professional medical advice. Consult your surgeon or healthcare provider before starting any pre-surgery preparation program, especially if you have existing health conditions, mobility limitations, or are taking medications. Results from this pilot study are preliminary and should not be considered definitive evidence of effectiveness until a full-scale trial is completed and published.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.