Implementing Exercise = Medicine in routine clinical care; needs for an online tool and key decisions for implementation of Exercise = Medicine within two Dutch academic hospitals.
Advice
Clinician
Decision-making
Digital health
Exercise is Medicine
Lifestyle
Physical activity
Prescription
Referral
Tool
Journal
BMC medical informatics and decision making
ISSN: 1472-6947
Titre abrégé: BMC Med Inform Decis Mak
Pays: England
ID NLM: 101088682
Informations de publication
Date de publication:
22 09 2022
22 09 2022
Historique:
received:
16
02
2022
accepted:
26
08
2022
entrez:
22
9
2022
pubmed:
23
9
2022
medline:
28
9
2022
Statut:
epublish
Résumé
There is much evidence to implement physical activity interventions for medical reasons in healthcare settings. However, the prescription of physical activity as a treatment, referring to as 'Exercise is Medicine' (E = M) is currently mostly absent in routine hospital care in The Netherlands. To support E = M prescription by clinicians in hospitals, this study aimed: (1) to develop an E = M-tool for physical activity advice and referrals to facilitate the E = M prescription in hospital settings; and (2) to provide an E = M decision guide on key decisions for implementation to prepare for E = M prescription in hospital care. A mixed method design was used employing a questionnaire and face-to-face interviews with clinicians, lifestyle coaches and hospital managers, a patient panel and stakeholders to assess the needs regarding an E = M-tool and key decisions for implementation of E = M. Based on the needs assessment, a digital E = M-tool was developed. The key decisions informed the development of an E = M decision guide. An online supportive tool for E = M was developed for two academic hospitals. Based on the needs assessment, linked to the different patients' electronic medical records and tailored to the two local settings (University Medical Center Groningen, Amsterdam University Medical Centers). The E = M-tool existed of a tool algorithm, including patient characteristics assessed with a digital questionnaire (age, gender, PA, BMI, medical diagnosis, motivation to change physical activity and preference to discuss physical activity with their doctor) set against norm values. The digital E = M-tool provided an individual E = M-prescription for patients and referral options to local PA interventions in- and outside the hospital. An E = M decision guide was developed to support the implementation of E = M prescription in hospital care. This study provided insight into E = M-tool development and the E = M decision-making to support E = M prescription and facilitate tailoring towards local E = M treatment options, using strong stakeholder participation. Outcomes may serve as an example for other decision support guides and interventions aimed at E = M implementation.
Sections du résumé
BACKGROUND
There is much evidence to implement physical activity interventions for medical reasons in healthcare settings. However, the prescription of physical activity as a treatment, referring to as 'Exercise is Medicine' (E = M) is currently mostly absent in routine hospital care in The Netherlands. To support E = M prescription by clinicians in hospitals, this study aimed: (1) to develop an E = M-tool for physical activity advice and referrals to facilitate the E = M prescription in hospital settings; and (2) to provide an E = M decision guide on key decisions for implementation to prepare for E = M prescription in hospital care.
METHODS
A mixed method design was used employing a questionnaire and face-to-face interviews with clinicians, lifestyle coaches and hospital managers, a patient panel and stakeholders to assess the needs regarding an E = M-tool and key decisions for implementation of E = M. Based on the needs assessment, a digital E = M-tool was developed. The key decisions informed the development of an E = M decision guide.
RESULTS
An online supportive tool for E = M was developed for two academic hospitals. Based on the needs assessment, linked to the different patients' electronic medical records and tailored to the two local settings (University Medical Center Groningen, Amsterdam University Medical Centers). The E = M-tool existed of a tool algorithm, including patient characteristics assessed with a digital questionnaire (age, gender, PA, BMI, medical diagnosis, motivation to change physical activity and preference to discuss physical activity with their doctor) set against norm values. The digital E = M-tool provided an individual E = M-prescription for patients and referral options to local PA interventions in- and outside the hospital. An E = M decision guide was developed to support the implementation of E = M prescription in hospital care.
CONCLUSIONS
This study provided insight into E = M-tool development and the E = M decision-making to support E = M prescription and facilitate tailoring towards local E = M treatment options, using strong stakeholder participation. Outcomes may serve as an example for other decision support guides and interventions aimed at E = M implementation.
Identifiants
pubmed: 36138451
doi: 10.1186/s12911-022-01993-5
pii: 10.1186/s12911-022-01993-5
pmc: PMC9494771
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
250Investigateurs
Willem van Mechelen
(W)
Vincent de Groot
(V)
Marike van der Leeden
(M)
Johannes Zwerver
(J)
Martin Fluit
(M)
Inge van den Akker-Scheek
(I)
Martin Stevens
(M)
Ronald Diercks
(R)
Willem Bossers
(W)
Laurien Buffart
(L)
Johan de Jong
(J)
Caroline Kampshoff
(C)
Hans Leutscher
(H)
Sacha van Twillert
(S)
Informations de copyright
© 2022. The Author(s).
Références
Int J Qual Health Care. 2004 Apr;16(2):107-23
pubmed: 15051705
BMJ Open. 2017 Feb 2;7(2):e012156
pubmed: 28153931
BMJ Open. 2022 Mar 15;12(3):e052920
pubmed: 35292491
Prev Med Rep. 2015 Jun 11;2:492-7
pubmed: 26844108
Arch Phys Med Rehabil. 2010 Dec;91(12):1856-61
pubmed: 21112426
Cancer. 2020 Jun 15;126(12):2750-2758
pubmed: 32212338
Prev Med Rep. 2021 Feb 04;22:101323
pubmed: 33659155
Curr Opin Cardiol. 2017 Sep;32(5):541-556
pubmed: 28708630
JMIR Mhealth Uhealth. 2019 Mar 25;7(3):e9869
pubmed: 30907740
Prev Chronic Dis. 2016 Feb 04;13:E16
pubmed: 26851335
Curr Sports Med Rep. 2016 May-Jun;15(3):207-14
pubmed: 27172086
Br J Sports Med. 2014 Dec;48(22):1627-33
pubmed: 24759911
Ann Surg. 2018 Jan;267(1):50-56
pubmed: 28489682
J Phys Act Health. 2015 Sep;12(9):1336-43
pubmed: 25459966
Support Care Cancer. 2018 Apr;26(4):1289-1295
pubmed: 29090387
Circulation. 2018 May 1;137(18):e495-e522
pubmed: 29618598
Lancet. 2012 Jul 21;380(9838):219-29
pubmed: 22818936
J Gen Intern Med. 2014 Feb;29(2):341-8
pubmed: 24309950
Med Sci Sports Exerc. 2012 Nov;44(11):2071-6
pubmed: 22688832
CA Cancer J Clin. 2019 Nov;69(6):468-484
pubmed: 31617590
Am J Health Promot. 1997 Sep-Oct;12(1):38-48
pubmed: 10170434
Br J Sports Med. 2011 May;45(6):473-4
pubmed: 21292925
Patient Educ Couns. 2015 Apr;98(4):412-9
pubmed: 25499578
BMC Med Inform Decis Mak. 2016 Jul 11;16:88
pubmed: 27401606
Cancer. 2016 Feb 1;122(3):470-6
pubmed: 26566177
JMIR Res Protoc. 2020 Nov 2;9(11):e19397
pubmed: 33136060
Osteoporos Int. 2017 Jun;28(6):1953-1963
pubmed: 28413842
J Clin Nurs. 2014 Jun;23(11-12):1486-501
pubmed: 24028657
Transl J Am Coll Sports Med. 2019 Jan 1;4(1):1-7
pubmed: 30828640
Ann Thorac Surg. 2019 Jun;107(6):1639-1646
pubmed: 30690020
Autoimmun Rev. 2018 Jan;17(1):53-72
pubmed: 29108826
Lancet Glob Health. 2018 Oct;6(10):e1077-e1086
pubmed: 30193830
Br J Sports Med. 2011 Mar;45(3):203-8
pubmed: 20484314
J Med Internet Res. 2017 Dec 07;19(12):e401
pubmed: 29217503
Br J Gen Pract. 2011 Mar;61(584):e125-33
pubmed: 21375895
BMC Fam Pract. 2013 Aug 29;14:128
pubmed: 23987804
Scand J Med Sci Sports. 2015 Dec;25 Suppl 3:1-72
pubmed: 26606383