Facilitators and barriers to the implementation of prehabilitation for frail patients into routine health care: a realist review.

"Declarations Ethics approval and consent to participateNot applicable. Consent for publicationNot applicable. Competing interestsAFS performed the research as part of her master’s thesis and declares no financial conflict of interest. JK, SJS, CS and TR are involved in an ongoing randomized clinical trial on prehabilitation in the frail elderly (PRAEP-GO; ClinicalTrials.gov identifier NCT04418271) funded by the Innovationsfonds des Gemeinsamen Bundesausschusses.JK declares no financial conflict of interest.Furthermore, SJS received grants and non-financial support from Reactive Robotics GmbH (Munich, Germany), ASP GmbH (Attendorn, Germany), STIMIT AG (Biel, Switzerland), ESICM (Geneva, Switzerland), grants, personal fees and non-financial support from Fresenius Kabi Deutschland GmbH (Bad Homburg, Germany), grants from the Innovationsfond of The Federal Joint Committee (G-BA), personal fees from Springer Verlag GmbH (Vienna, Austria) for educational purposes and Advanz Pharma GmbH (Bielefeld, Germany), non-financial support from national and international societies (and their congress organizers) in the field of anesthesiology and intensive care medicine, outside the submitted work. Dr. Schaller holds stocks in small amounts from Alphabeth Inc., Bayer AG and Siemens AG; these holdings have not affected any decisions regarding his research or this study.CS reports grants from Innovationsfonds des Gemeinsamen Bundesausschusses, Bundesministerium für Bildung und Forschung, Bundesministerium für Gesundheit/Robert Koch-Institut, Deutsche Forschungsgemeinschaft, Deutsches Zentrum für Luft- und Raumfahrt e. V., Einstein Stiftung Berlin, Inneruniversitäre Forschungsförderung, European Society of Anaesthesiology and Intensive Care, Baxter Deutschland GmbH, Cytosorbents Europe GmbH, Edwards Lifesciences Germany GmbH, Fresenius Medical Care, Grünenthal GmbH, Masimo Europe Ltd., Pfizer Pharma GmbH, Dr. F. Köhler Chemie GmbH, Sintetica GmbH, Stifterverband für die deutsche Wissenschaft e.V./Phillips, Stiftung Charité, AGUETTANT Deutschland GmbH, AbbVie Deutschland GmbH & Co. KG, Amomed Pharma GmbH, InTouch Health, Copra System GmbH, Correvio GmbH, Max-Planck-Gesellschaft zur Förderung der Wissenschaften e.V., Deutsche Gesellschaft für Anästhesiologie & Intensivmedizin, Stifterverband für die deutsche Wissenschaft e.V./Metronic, Philips Electronics Nederland BV, Drägerwerk AG & Co. KGaA; personal fees from Georg Thieme Verlag, all outside the submitted work.TR received honorary fees for commissioned research by the Statutory Health Insurance Medical Review Board outside the submitted work. Competing interests AFS performed the research as part of her master’s thesis and declares no financial conflict of interest. JK, SJS, CS and TR are involved in an ongoing randomized clinical trial on prehabilitation in the frail elderly (PRAEP-GO; ClinicalTrials.gov identifier NCT04418271) funded by the Innovationsfonds des Gemeinsamen Bundesausschusses. JK declares no financial conflict of interest. Furthermore, SJS received grants and non-financial support from Reactive Robotics GmbH (Munich, Germany), ASP GmbH (Attendorn, Germany), STIMIT AG (Biel, Switzerland), ESICM (Geneva, Switzerland), grants, personal fees and non-financial support from Fresenius Kabi Deutschland GmbH (Bad Homburg, Germany), grants from the Innovationsfond of The Federal Joint Committee (G-BA), personal fees from Springer Verlag GmbH (Vienna, Austria) for educational purposes and Advanz Pharma GmbH (Bielefeld, Germany), non-financial support from national and international societies (and their congress organizers) in the field of anesthesiology and intensive care medicine, outside the submitted work. Dr. Schaller holds stocks in small amounts from Alphabeth Inc., Bayer AG and Siemens AG; these holdings have not affected any decisions regarding his research or this study. CS reports grants from Innovationsfonds des Gemeinsamen Bundesausschusses, Bundesministerium für Bildung und Forschung, Bundesministerium für Gesundheit/Robert Koch-Institut, Deutsche Forschungsgemeinschaft, Deutsches Zentrum für Luft- und Raumfahrt e. V., Einstein Stiftung Berlin, Inneruniversitäre Forschungsförderung, European Society of Anaesthesiology and Intensive Care, Baxter Deutschland GmbH, Cytosorbents Europe GmbH, Edwards Lifesciences Germany GmbH, Fresenius Medical Care, Grünenthal GmbH, Masimo Europe Ltd., Pfizer Pharma GmbH, Dr. F. Köhler Chemie GmbH, Sintetica GmbH, Stifterverband für die deutsche Wissenschaft e.V./Phillips, Stiftung Charité, AGUETTANT Deutschland GmbH, AbbVie Deutschland GmbH & Co. KG, Amomed Pharma GmbH, InTouch Health, Copra System GmbH, Correvio GmbH, Max-Planck-Gesellschaft zur Förderung der Wissenschaften e.V., Deutsche Gesellschaft für Anästhesiologie & Intensivmedizin, Stifterverband für die deutsche Wissenschaft e.V./Metronic, Philips Electronics Nederland BV, Drägerwerk AG & Co. KGaA; personal fees from Georg Thieme Verlag, all outside the submitted work. TR received honorary fees for commissioned research by the Statutory Health Insurance Medical Review Board outside the submitted work."

"Funding Open Access funding enabled and organized by Projekt DEAL. This study received no extra-mural funding. Open Access funding enabled and organized by Projekt DEAL."

"Trial registration PROSPERO (CRD42022335282)."