TY - JOUR
T1 - 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
AU - Bouma, Adrie
AU - van Nassau, Femke
AU - Nauta, Joske
AU - Krops, Leonie
AU - van der Ploeg, Hidde
AU - Verhagen, Evert
AU - van der Woude, Lucas
AU - van Keeken, Helco
AU - Dekker, Rienk
AU - van Mechelen, Willem
AU - de Groot, Vincent
AU - van der Leeden, Marike
AU - Zwerver, Johannes
AU - PIE = M consortium
AU - Fluit, Martin
AU - van den Akker-Scheek, Inge
AU - Stevens, Martin
AU - Diercks, Ronald
AU - Bossers, Willem
AU - Buffart, Laurien
AU - de Jong, Johan
AU - Kampshoff, Caroline
AU - Leutscher, Hans
AU - van Twillert, Sacha
N1 - Funding Information: This study was supported by a grant from ZonMw (Grant ID 546001002). This funding body did not have a role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. Publisher Copyright: © 2022, The Author(s).
PY - 2022/12/1
Y1 - 2022/12/1
N2 - 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.
AB - 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.
KW - Advice
KW - Clinician
KW - Decision-making
KW - Digital health
KW - Exercise is Medicine
KW - Lifestyle
KW - Physical activity
KW - Prescription
KW - Referral
KW - Tool
UR - http://www.scopus.com/inward/record.url?scp=85138381574&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12911-022-01993-5
DO - https://doi.org/10.1186/s12911-022-01993-5
M3 - Article
C2 - 36138451
SN - 1472-6947
VL - 22
JO - BMC medical informatics and decision making
JF - BMC medical informatics and decision making
IS - 1
M1 - 250
ER -