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

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...

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Published in:European journal of preventive cardiology 2018-05, Vol.25 (7), p.682-691
Main Authors: 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
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cited_by cdi_FETCH-LOGICAL-c415t-69959e348f6235205311b34da80cb53816f459d3bd06ecc9c7fb4266c2bb91aa3
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container_title European journal of preventive cardiology
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creator 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
description 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 
doi_str_mv 10.1177/2047487318760888
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Findings from the EAPC EXPERT working group survey</title><source>Oxford Journals Online</source><creator>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</creator><creatorcontrib>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 ; EAPC EXPERT working group</creatorcontrib><description>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 &lt; 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.</description><identifier>ISSN: 2047-4873</identifier><identifier>EISSN: 2047-4881</identifier><identifier>DOI: 10.1177/2047487318760888</identifier><identifier>PMID: 29486587</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><ispartof>European journal of preventive cardiology, 2018-05, Vol.25 (7), p.682-691</ispartof><rights>The European Society of Cardiology 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-69959e348f6235205311b34da80cb53816f459d3bd06ecc9c7fb4266c2bb91aa3</citedby><cites>FETCH-LOGICAL-c415t-69959e348f6235205311b34da80cb53816f459d3bd06ecc9c7fb4266c2bb91aa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29486587$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hansen, Dominique</creatorcontrib><creatorcontrib>Rovelo Ruiz, Gustavo</creatorcontrib><creatorcontrib>Doherty, Patrick</creatorcontrib><creatorcontrib>Iliou, Marie-Christine</creatorcontrib><creatorcontrib>Vromen, Tom</creatorcontrib><creatorcontrib>Hinton, Sally</creatorcontrib><creatorcontrib>Frederix, Ines</creatorcontrib><creatorcontrib>Wilhelm, Matthias</creatorcontrib><creatorcontrib>Schmid, Jean-Paul</creatorcontrib><creatorcontrib>Abreu, Ana</creatorcontrib><creatorcontrib>Ambrosetti, Marco</creatorcontrib><creatorcontrib>Garcia-Porrero, Esteban</creatorcontrib><creatorcontrib>Coninx, Karin</creatorcontrib><creatorcontrib>Dendale, Paul</creatorcontrib><creatorcontrib>EAPC EXPERT working group</creatorcontrib><title>Do clinicians prescribe exercise similarly in patients with different cardiovascular diseases? Findings from the EAPC EXPERT working group survey</title><title>European journal of preventive cardiology</title><addtitle>Eur J Cardiovasc Prev Rehabil</addtitle><description>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 &lt; 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.</description><issn>2047-4873</issn><issn>2047-4881</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kU1P3DAQhq2qqCDg3hPykUvAX3HsU4W2S6mEVFRRqbfIcSaLaRIHTwLdn9F_XKMFDpU6l_l65pVmhpCPnJ1xXlXngqlKmUpyU2lmjHlHDp5LhTKGv3-LK7lPjhHvWTbNhDDmA9kXVhldmuqA_Pkcqe_DGHxwI9IpAfoUGqDwG5IPCBTDEHqX-i0NI53cHGCckT6F-Y62oesg5Zx6l9oQHx36JbO5geAQ8BO9DGMbxg3SLsWBzndA1xc3K7r-ebP-fkufYvqVu3ST4jJRXNIjbI_IXud6hOMXf0h-XK5vV1fF9bcvX1cX14VXvJwLbW1pQSrTaSFLwUrJeSNV6wzzTSkN150qbSublmnw3vqqa5TQ2oumsdw5eUhOd7pTig8L4FwPAT30vRshLlgLxqzgyvIyo2yH-hQRE3T1lMLg0rbmrH7-Rf3vL_LIyYv60gzQvg28Xj4DxQ5At4H6Pi5pzNv-X_Av3gCSzw</recordid><startdate>201805</startdate><enddate>201805</enddate><creator>Hansen, Dominique</creator><creator>Rovelo Ruiz, Gustavo</creator><creator>Doherty, Patrick</creator><creator>Iliou, Marie-Christine</creator><creator>Vromen, Tom</creator><creator>Hinton, Sally</creator><creator>Frederix, Ines</creator><creator>Wilhelm, Matthias</creator><creator>Schmid, Jean-Paul</creator><creator>Abreu, Ana</creator><creator>Ambrosetti, Marco</creator><creator>Garcia-Porrero, Esteban</creator><creator>Coninx, Karin</creator><creator>Dendale, Paul</creator><general>SAGE Publications</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201805</creationdate><title>Do clinicians prescribe exercise similarly in patients with different cardiovascular diseases? Findings from the EAPC EXPERT working group survey</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-69959e348f6235205311b34da80cb53816f459d3bd06ecc9c7fb4266c2bb91aa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hansen, Dominique</creatorcontrib><creatorcontrib>Rovelo Ruiz, Gustavo</creatorcontrib><creatorcontrib>Doherty, Patrick</creatorcontrib><creatorcontrib>Iliou, Marie-Christine</creatorcontrib><creatorcontrib>Vromen, Tom</creatorcontrib><creatorcontrib>Hinton, Sally</creatorcontrib><creatorcontrib>Frederix, Ines</creatorcontrib><creatorcontrib>Wilhelm, Matthias</creatorcontrib><creatorcontrib>Schmid, Jean-Paul</creatorcontrib><creatorcontrib>Abreu, Ana</creatorcontrib><creatorcontrib>Ambrosetti, Marco</creatorcontrib><creatorcontrib>Garcia-Porrero, Esteban</creatorcontrib><creatorcontrib>Coninx, Karin</creatorcontrib><creatorcontrib>Dendale, Paul</creatorcontrib><creatorcontrib>EAPC EXPERT working group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of preventive cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hansen, Dominique</au><au>Rovelo Ruiz, Gustavo</au><au>Doherty, Patrick</au><au>Iliou, Marie-Christine</au><au>Vromen, Tom</au><au>Hinton, Sally</au><au>Frederix, Ines</au><au>Wilhelm, Matthias</au><au>Schmid, Jean-Paul</au><au>Abreu, Ana</au><au>Ambrosetti, Marco</au><au>Garcia-Porrero, Esteban</au><au>Coninx, Karin</au><au>Dendale, Paul</au><aucorp>EAPC EXPERT working group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Do clinicians prescribe exercise similarly in patients with different cardiovascular diseases? Findings from the EAPC EXPERT working group survey</atitle><jtitle>European journal of preventive cardiology</jtitle><addtitle>Eur J Cardiovasc Prev Rehabil</addtitle><date>2018-05</date><risdate>2018</risdate><volume>25</volume><issue>7</issue><spage>682</spage><epage>691</epage><pages>682-691</pages><issn>2047-4873</issn><eissn>2047-4881</eissn><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 &lt; 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.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>29486587</pmid><doi>10.1177/2047487318760888</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
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title Do clinicians prescribe exercise similarly in patients with different cardiovascular diseases? Findings from the EAPC EXPERT working group survey
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