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

Dominique Hansen; Gustavo Rovelo Ruiz; Patrick Joseph Doherty; Marie-Christine Illiou; Tom Vromen; Sally Hinton; Ines Frederix; Matthias Wilhelm; Jean-Paul Schmid; Ana Abreu; Marco Ambrosetti; Esteban Garcia-Porrero; Karin Coninx; Paul Dendale

doi:10.1177/2047487318760888

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

Dominique Hansen, Gustavo Rovelo Ruiz, Patrick Joseph Doherty, Marie-Christine Illiou, Tom Vromen, Sally Hinton, Ines Frederix, Matthias Wilhelm, Jean-Paul Schmid, Ana Abreu, Marco Ambrosetti, Esteban Garcia-Porrero, Karin Coninx, Paul Dendale

Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

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 (HRpeak)), 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 HRpeak), 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.

Original language	English
Number of pages	10
Journal	European journal of preventive cardiology
DOIs	https://doi.org/10.1177/2047487318760888
Publication status	Published - 28 Feb 2018

Bibliographical note

© The European Society of Cardiology 2018. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details

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10.1177/2047487318760888

Hansen et al EXPERT survey pre publication version
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Cite this

Hansen, D., Rovelo Ruiz, G., Doherty, P. J., Illiou, M.-C., Vromen, T., Hinton, S., Frederix, I., Wilhelm, M., Schmid, J.-P., Abreu, A., Ambrosetti, M., Garcia-Porrero, E., Coninx, K., & Dendale, P. (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. https://doi.org/10.1177/2047487318760888

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

abstract = "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 (HRpeak)), 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 HRpeak), 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{\textquoteright} 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.",

author = "Dominique Hansen and {Rovelo Ruiz}, Gustavo and Doherty, {Patrick Joseph} and Marie-Christine Illiou and Tom Vromen and Sally Hinton and Ines Frederix and Matthias Wilhelm and Jean-Paul Schmid and Ana Abreu and Marco Ambrosetti and Esteban Garcia-Porrero and Karin Coninx and Paul Dendale",

note = "{\textcopyright} The European Society of Cardiology 2018. This is an author-produced version of the published paper. Uploaded in accordance with the publisher{\textquoteright}s self-archiving policy. Further copying may not be permitted; contact the publisher for details",

year = "2018",

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Hansen, D, Rovelo Ruiz, G, Doherty, PJ, Illiou, M-C, Vromen, T, Hinton, S, Frederix, I, Wilhelm, M, Schmid, J-P, Abreu, A, Ambrosetti, M, Garcia-Porrero, E, Coninx, K & Dendale, P 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. https://doi.org/10.1177/2047487318760888

TY - JOUR

T1 - Do clinicians prescribe exercise similarly in patients with different cardiovascular diseases? Findings from the EAPC EXPERT working group survey

AU - Hansen, Dominique

AU - Rovelo Ruiz, Gustavo

AU - Doherty, Patrick Joseph

AU - Illiou, Marie-Christine

AU - Vromen, Tom

AU - Hinton, Sally

AU - Frederix, Ines

AU - Wilhelm, Matthias

AU - Schmid, Jean-Paul

AU - Abreu, Ana

AU - Ambrosetti, Marco

AU - Garcia-Porrero, Esteban

AU - Coninx, Karin

AU - Dendale, Paul

N1 - © The European Society of Cardiology 2018. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details

PY - 2018/2/28

Y1 - 2018/2/28

N2 - 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 (HRpeak)), 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 HRpeak), 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.

AB - 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 (HRpeak)), 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 HRpeak), 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.

U2 - 10.1177/2047487318760888

DO - 10.1177/2047487318760888

M3 - Article

SN - 2047-4873

JO - European journal of preventive cardiology

JF - European journal of preventive cardiology

ER -