Facilitators and barriers for the implementation of exercise are medicine in routine clinical care in Dutch university medical centres: a mixed methodology study on clinicians' perceptions

Joske Nauta*, Femke van Nassau, Adrie Bouma, Leonie Krops, Hidde P van der Ploeg, Evert Verhagen, L. H. V. van der Woude, Helco van Keeken, Laurien M. Buffart, Ron L. Diercks, Vincent de Groot, Johan de Jong, Caroline S Kampshoff, Martin Stevens, Inge van den Akker-Scheek, Marike van der Leeden, willem van mechelen, Rienk Dekker

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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OBJECTIVES: Despite the many proven advantages of a physically active lifestyle in patient populations, prescription of exercise is currently not widely implemented in routine clinical practice. The aims of this study were twofold: (1) to assess perceptions of clinicians on the current practice of exercise is medicine (E=M) prescription in two Dutch university medical centres and (2) to determine their perceived barriers and facilitators for the implementation of E=M in routine clinical care in Dutch university medical centres.

DESIGN: A mixed methodologies study, using both online questionnaires and semi-structured interviews.

SETTING: Dutch university medical centres.

PARTICIPANTS: Clinicians working within the departments of medical oncology, orthopaedics and rehabilitation medicine of two university medical centres.

RESULTS: Forty-five clinicians (response rate of 51%) completed the questionnaire, and 19 clinicians were interviewed. The results showed that even though clinicians had a positive attitude towards prescribing E=M, only a few reported to regularly prescribe E=M to their patients. The 52 identified facilitators and barriers for implementation of E=M were categorised into four main themes: (1) beliefs toward the implementation of E=M (eg, clinicians knowledge and skills, and social support), (2) factors related to the patient perspective (eg, patient priorities or motivation), (3) factors related to the referral options (eg, knowledge of and trust in local referral options) and (4) practical considerations when implementing E=M (eg, time constraints).

CONCLUSIONS: Our study showed that even though many clinicians have a positive attitude toward an active lifestyle, many are not prescribing E=M on a regular basis. In order for clinicians to effectively implement E=M, strategies should focus on increasing clinicians E=M referral skills, improving clinicians knowledge of E=M referral options and develop a support system to ensure that E=M is high on the priority list of clinicians.

Original languageEnglish
Article numbere052920
Number of pages14
JournalBMJ Open
Issue number3
Early online date15-Mar-2022
Publication statusPublished - 2022



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