Integration of prehabilitation into perioperative care: A multidomain cross-sectional analysis of prehabilitation practice among anaesthetists across academic and non-academic settings

BACKGROUND: Prehabilitation is recognised as an important component of perioperative optimisation. Data regarding anaesthetists' involvement in prehabilitation and factors influencing its implementation are limited. AIM: To evaluate the understanding, adoption, access and implementation of prehabilitation among anaesthetists in India and identify factors associated with implementation behaviour. METHODS: A nationwide survey of anaesthetists was conducted using a validated questionnaire assessing knowledge, role engagement, system support, implementation, barriers and innovation readiness. Quantitative data underwent correlation and regression analyses; qualitative responses were thematically mapped to the Consolidated Framework for Implementation Research. RESULTS: Among 259 respondents, awareness of prehabilitation was high, but only 32.4% routinely referred patients. Higher Implementation Scores were noted in enhanced recovery after surgery-based settings. Digital readiness, current understanding, enhanced recovery after surgery practice and academic association independently predicted implementation. Qualitative findings emphasised structured referral pathways, multidisciplinary collaboration and organisational support involving the wider perioperative team. CONCLUSION: Despite positive perceptions, prehabilitation implementation remains limited. Organisational readiness, enhanced recovery after surgery integration and digital enablement may be key drivers of adoption.