TY - JOUR
T1 - Supervised exercise therapy for intermittent claudication is increasingly endorsed by Dutch vascular surgeons
AU - Hageman, David
AU - Lauret, Gert Jan
AU - Gommans, Lindy N.M.
AU - Koelemay, Mark J.W.
AU - van Sambeek, Marc R.H.M.
AU - Scheltinga, Marc R.M.
AU - Teijink, Joep A.W.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Background: Although supervised exercise therapy (SET) is generally accepted as an effective noninvasive treatment for intermittent claudication (IC), Dutch vascular surgeons were initially somewhat hesitant as reported by a 2011 questionnaire study. Later on, a nationwide multidisciplinary network for SET was introduced in the Netherlands. The aim of this questionnaire study was to determine possible trends in conceptions among Dutch vascular surgeons regarding the prescription of SET. Methods: In the year of 2015, Dutch vascular surgeons, fellows, and senior residents were asked to complete a 26-item questionnaire including issues that were considered relevant for prescribing SET such as patient selection criteria and comorbidity. Outcome was compared to the 2011 survey. Results: Data of 124 respondents (82% males; mean age 46 years; 64% response rate) were analyzed. SET referral rate of new IC patients was not different over time (2015: 81% vs. 2011: 75%; P = 0.295). However, respondents were more willing to prescribe SET in IC patients with chronic obstructive pulmonary disease (2015: 86% vs. 2011: 69%; P = 0.002). Nevertheless, a smaller portion of respondents found that SET was also indicated for aortoiliac disease (2015: 63% vs. 2011: 76%; P = 0.049). Insufficient health insurance coverage and/or personal financial resources were the most important presumed barriers preventing patients from initiating SET (80% of respondents). Moreover, 94% of respondents judged that SET should be fully reimbursed by all Dutch basic health insurances. Conclusions: The concept of SET for IC is nowadays generally embraced by the vast majority of Dutch vascular surgeons. SET may have gained in popularity in IC patients with cardiopulmonary comorbidity. However, SET remains underutilized for aortoiliac disease. Reimbursement is considered crucial for a successful SET implementation.
AB - Background: Although supervised exercise therapy (SET) is generally accepted as an effective noninvasive treatment for intermittent claudication (IC), Dutch vascular surgeons were initially somewhat hesitant as reported by a 2011 questionnaire study. Later on, a nationwide multidisciplinary network for SET was introduced in the Netherlands. The aim of this questionnaire study was to determine possible trends in conceptions among Dutch vascular surgeons regarding the prescription of SET. Methods: In the year of 2015, Dutch vascular surgeons, fellows, and senior residents were asked to complete a 26-item questionnaire including issues that were considered relevant for prescribing SET such as patient selection criteria and comorbidity. Outcome was compared to the 2011 survey. Results: Data of 124 respondents (82% males; mean age 46 years; 64% response rate) were analyzed. SET referral rate of new IC patients was not different over time (2015: 81% vs. 2011: 75%; P = 0.295). However, respondents were more willing to prescribe SET in IC patients with chronic obstructive pulmonary disease (2015: 86% vs. 2011: 69%; P = 0.002). Nevertheless, a smaller portion of respondents found that SET was also indicated for aortoiliac disease (2015: 63% vs. 2011: 76%; P = 0.049). Insufficient health insurance coverage and/or personal financial resources were the most important presumed barriers preventing patients from initiating SET (80% of respondents). Moreover, 94% of respondents judged that SET should be fully reimbursed by all Dutch basic health insurances. Conclusions: The concept of SET for IC is nowadays generally embraced by the vast majority of Dutch vascular surgeons. SET may have gained in popularity in IC patients with cardiopulmonary comorbidity. However, SET remains underutilized for aortoiliac disease. Reimbursement is considered crucial for a successful SET implementation.
KW - Adult
KW - Attitude of Health Personnel
KW - Exercise Therapy/statistics & numerical data
KW - Female
KW - Humans
KW - Insurance Coverage
KW - Insurance, Health
KW - Intermittent Claudication/rehabilitation
KW - Internship and Residency
KW - Male
KW - Middle Aged
KW - Netherlands
KW - Surgeons
KW - Surveys and Questionnaires
KW - Vascular Surgical Procedures
KW - Walk Test
UR - http://www.scopus.com/inward/record.url?scp=85030481765&partnerID=8YFLogxK
U2 - 10.1016/j.avsg.2017.08.022
DO - 10.1016/j.avsg.2017.08.022
M3 - Article
C2 - 28893711
AN - SCOPUS:85030481765
SN - 0890-5096
VL - 47
SP - 149
EP - 156
JO - Annals of Vascular Surgery
JF - Annals of Vascular Surgery
ER -