TY - JOUR
T1 - Facilitators and barriers for the implementation of exercise are medicine in routine clinical care in Dutch university medical centres
T2 - a mixed methodology study on clinicians' perceptions
AU - Nauta, Joske
AU - van Nassau, Femke
AU - Bouma, Adrie
AU - Krops, Leonie
AU - van der Ploeg, Hidde P
AU - Verhagen, Evert
AU - van der Woude, L. H. V.
AU - van Keeken, Helco
AU - Buffart, Laurien M.
AU - Diercks, Ron L.
AU - de Groot, Vincent
AU - de Jong, Johan
AU - Kampshoff, Caroline S
AU - Stevens, Martin
AU - van den Akker-Scheek, Inge
AU - van der Leeden, Marike
AU - van mechelen, willem
AU - Dekker, Rienk
N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - PREVENTIVE MEDICINE
KW - QUALITATIVE RESEARCH
KW - SPORTS MEDICINE
KW - ORTHOPAEDIC & TRAUMA SURGERY
KW - REHABILITATION MEDICINE
KW - ONCOLOGY
KW - PHYSICAL-ACTIVITY
KW - CANCER
KW - PATIENT
U2 - 10.1136/bmjopen-2021-052920
DO - 10.1136/bmjopen-2021-052920
M3 - Article
C2 - 35292491
SN - 2044-6055
VL - 12
JO - BMJ Open
JF - BMJ Open
IS - 3
M1 - e052920
ER -