Improved Adherence to a Stepped Care Model Reduces Costs of Intermittent Claudication Treatment in the Netherlands

Hageman, David; Fokkenrood, H.J.P.; Essers, Peter-Paul; Koelemay, M.J.W.; Breek, J.C.; Vahl, A.C.; Scheltinga, Marc; Teijink, Joep A.W.

doi:10.1016/j.ejvs.2019.06.560

Cited by 6 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In patients with IC in the Netherlands (ClaudicatioNet) and osteoarthritis in Denmark, Canada, Australia and China [31,32,33], training health care practitioners in delivering evidence-based treatment is a successful way to implement evidence in clinical practice. Furthermore, a systematic and structured implementation of rehabilitation including SET as part of everyday clinical practice seems to be cost-effective [12]. Building on these previous experiences and the findings of the current study offers a feasible and attractive way forward to improve the quality of care of patients with IC in Denmark and perhaps to prevent future cardiovascular mortality and morbidity [34].…”

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

National survey of current practice and opinions on rehabilitation for intermittent claudication in the Danish Public Healthcare System

Jensen

Tang

Zwisler

et al. 2019

Scandinavian Cardiovascular Journal

View full text Add to dashboard Cite

Brief statement on what this study will add to the existing literature and how will it influence future clinical practice: Knowledge about implementation of guideline recommendations of rehabilitation for patients with Intermittent Claudication is scarce. We systematically investigated current clinical practice on a national level, providing an important overview of current care and the foundation needed to ensure proper implementation in clinical practice. Despite strong supportive evidence, our study demonstrated that rehabilitation, and in particular supervised exercise therapy, is still a largely underutilized tool. As all vascular surgeons would refer patients to rehabilitation if available, our study supports the development of a structured, evidence-based rehabilitation program with the potential of improving care for a large population of patients.

show abstract

Section: Discussionmentioning

confidence: 94%

“…SET is effective as a rehabilitation strategy in ˃80% of the patients with IC [4,5,6,7,8], and it improves the functional status and health-related quality of life (QOL) [3,4,5]. Trials with long-term follow-up indicate a persistent benefit of SET in patients with IC [9,10,11], and SET is cost-effective as rehabilitation [12].…”

Section: Introductionmentioning

confidence: 99%

National survey of current practice and opinions on rehabilitation for intermittent claudication in the Danish Public Healthcare System

Jensen

Tang

Zwisler

et al. 2019

Scandinavian Cardiovascular Journal

View full text Add to dashboard Cite

show abstract

“…In addition to inconsistencies in the recommendations for exercise, there is also variability in the delivery of exercise programmes globally with some clinicians reporting lack of expertise or support to guide the exercise delivery. [19][20][21] This guideline for practitioners aims to accompany these consensus guidelines to provide a succinct but more detailed overview of, and recommendations for, exercise prescription and training for IC. While we appreciate that delivery and provision will vary, the key exercise prescription components will remain and as such, this document will be relevant for exercise practitioners worldwide.…”

Section: What This Study Adds?mentioning

confidence: 99%

Exercise training for intermittent claudication: a narrative review and summary of guidelines for practitioners

Harwood

Pymer

Ingle

et al. 2020

BMJ Open Sport Exerc Med

View full text Add to dashboard Cite

Peripheral artery disease (PAD) is caused by atherosclerotic narrowing of the arteries supplying the lower limbs often resulting in intermittent claudication, evident as pain or cramping while walking. Supervised exercise training elicits clinically meaningful benefits in walking ability and quality of life. Walking is the modality of exercise with the strongest evidence and is recommended in several national and international guidelines. Alternate forms of exercise such as upper- or lower-body cycling may be used, if required by certain patients, although there is less evidence for these types of programmes. The evidence for progressive resistance training is growing and patients can also engage in strength-based training alongside a walking programme. For those unable to attend a supervised class (strongest evidence), home-based or ‘self-facilitated’ exercise programmes are known to improve walking distance when compared to simple advice. All exercise programmes, independent of the mode of delivery, should be progressive and individually prescribed where possible, considering disease severity, comorbidities and initial exercise capacity. All patients should aim to accumulate at least 30 min of aerobic activity, at least three times a week, for at least 3 months, ideally in the form of walking exercise to near-maximal claudication pain.

show abstract

“…Gernigon et al [5] performed in 2014 the first clinical applicability of a global positioning system (GPS) to monitor walking abilities of PAD patients. More recently, Khambati et al [8] have tested the accuracy of GPS based mapping tools to become a measurement of walking distance in PAD patients. The authors used Google Maps as a GPS based mapping tool, and the results showed that: "it offers an accurate, efficient, inexpensive, and readily accessible way to assess walking distances in patients with PAD" [8].…”

Section: Peripheral Artery Disease (Pad)mentioning

confidence: 99%

“…Exercise programs are an effective, low cost, lowrisk option compared with more invasive therapies for IC [3]. Structured community-or home-based exercise programs take place in the personal setting of the patient rather than in a clinical setting [8]. Programs are selfdirected with guidance of healthcare providers that prescribe an exercise regimen similar to a supervised program [14].…”

Section: Introductionmentioning

confidence: 99%

Supervised physical exercise therapy of peripheral artery disease patients: M-health challenges and opportunities

Paredes¹,

Paulino²,

Barroso³

et al. 2021

Proceedings of the Annual Hawaii International Conference on System Sciences

View full text Add to dashboard Cite

Peripheral artery disease (PAD) main symptom is intermittent claudication, causing pain and limiting the walking abilities of patients, forcing individuals to temporarily stop walking. One treatment advised to counteract the effects of this disease is the practice of physical exercise with monitoring. Currently the monitored exercise programs are applied at the hospital, so some patients have to travel long distances three times a week, with high costs and low adherence of the patients. This paper presents the cocreation process of a mobile application for quantified supervised home-based exercise therapy on PAD patients. The study aimed to design a solution adapted to users' needs, which collects the necessary information for the therapy supervision by health professionals. The users' behaviour with the application allowed the assessment to a set of limitations and potential sources of noise in the supervision data that suggest the evolution to a pervasive solution, by minimizing, or even eliminating, the interaction with the users. The developed tool is a first step towards the creation of a technological ecosystem for the prescription of supervised therapeutic physical exercise, which leverages self-care and allows access to this type of therapy to the entire population. Cardiovascular disease represents a considerable economic burden to society, therefore effective preventive measures are necessary.

show abstract

Improved Adherence to a Stepped Care Model Reduces Costs of Intermittent Claudication Treatment in the Netherlands

Cited by 6 publications

References 0 publications

National survey of current practice and opinions on rehabilitation for intermittent claudication in the Danish Public Healthcare System

National survey of current practice and opinions on rehabilitation for intermittent claudication in the Danish Public Healthcare System

Exercise training for intermittent claudication: a narrative review and summary of guidelines for practitioners

Supervised physical exercise therapy of peripheral artery disease patients: M-health challenges and opportunities

Contact Info

Product

Resources

About