Do clinicians prescribe exercise similarly in patients with different cardiovascular diseases? Findings from the EAPC EXPERT working group survey.

Hansen, Dominique; Rovelo Ruiz, Gustavo; Doherty, Patrick; Iliou, Marie-Christine; Vromen, Tom; Hinton, Sally; Frederix, Ines; Wilhelm, Matthias; Schmid, Jean-Paul; Abreu, Ana; Ambrosetti, Marco; Garcia-Porrero, Esteban; Coninx, Karin; Dendale, Paul (2018). Do clinicians prescribe exercise similarly in patients with different cardiovascular diseases? Findings from the EAPC EXPERT working group survey. European journal of preventive cardiology, 25(7), pp. 682-691. SAGE Publications 10.1177/2047487318760888

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Background Although disease-specific exercise guidelines for cardiovascular disease (CVD) are widely available, it remains uncertain whether these different exercise guidelines are integrated properly for patients with different CVDs. The aim of this study was to assess the inter-clinician variance in exercise prescription for patients with various CVDs and to compare these prescriptions with recommendations from the EXercise Prescription in Everyday practice and Rehabilitative Training (EXPERT) tool, a digital decision support system for integrated state-of-the-art exercise prescription in CVD. Design The study was a prospective observational survey. Methods Fifty-three CV rehabilitation clinicians from nine European countries were asked to prescribe exercise intensity (based on percentage of peak heart rate (HR)), frequency, session duration, programme duration and exercise type (endurance or strength training) for the same five patients. Exercise prescriptions were compared between clinicians, and relationships with clinician characteristics were studied. In addition, these exercise prescriptions were compared with recommendations from the EXPERT tool. Results A large inter-clinician variance was found for prescribed exercise intensity (median (interquartile range (IQR)): 83 (13) % of HR), frequency (median (IQR): 4 (2) days/week), session duration (median (IQR): 45 (18) min/session), programme duration (median (IQR): 12 (18) weeks), total exercise volume (median (IQR): 1215 (1961) peak-effort training hours) and prescription of strength training exercises (prescribed in 78% of all cases). Moreover, clinicians' exercise prescriptions were significantly different from those of the EXPERT tool ( p < 0.001). Conclusions This study reveals significant inter-clinician variance in exercise prescription for patients with different CVDs and disagreement with an integrated state-of-the-art system for exercise prescription, justifying the need for standardization efforts regarding integrated exercise prescription in CV rehabilitation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Wilhelm, Matthias

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2047-4873

Publisher:

SAGE Publications

Language:

English

Submitter:

Michelle Dysli

Date Deposited:

08 Feb 2019 14:52

Last Modified:

08 Feb 2019 14:52

Publisher DOI:

10.1177/2047487318760888

PubMed ID:

29486587

Uncontrolled Keywords:

Cardiovascular disease EXPERT tool exercise prescription

URI:

https://boris.unibe.ch/id/eprint/121850

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