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Voortgangsverslag

Samenvatting
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De algemene doelstelling van het project PIE=M (Physicians Implement Exercise = Medicine) is het stimuleren van een actieve leefstijl bij patiënten, ten einde bijvoorbeeld complicaties te voorkomen en gebruik van medicijnen te verminderen. Om deze doelen te bereiken is het project gericht op 3 concrete uitkomsten.

Ten eerste zal informatie worden verzameld over de huidige toepassing van E=M (actieve leefstijlinitiatieven) door te inventariseren welke drempels, stimulansen en behoeftes op dat vlak worden ervaren door clinici (o.a. artsen) en managers in ziekenhuizen.

Ten tweede zal er een instrument (algoritme) , gebaseerd op een elektronisch patiëntendossier, worden ontwikkeld en onderzocht op praktische werkbaarheid. Het instrument dient de clinicus te motiveren en te stimuleren om actieve leefstijl als medicijn (meer) toe te gaan passen. Het algoritme wordt daarbij gebaseerd op individuele patiëntkarakteristieken maar ook op referentiegegevens uit big data-bestanden.

Ten derde zal een implementatieplan voor brede toepassingsmogelijkheden in de ziekenhuiszorg in worden ontwikkeld.

 

Resultaten
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Stand van zaken, halverwege het project: (on track)

 

Informatie over de huidige stand van implementatie (en de daaraan gerelateerde factoren) van E=M is beschikbaar en is gebruikt als basisinformatie voor zowel de ontwikkeling van het instrument (algoritme) als het implementatieplan. Het ontwikkelde instrument is gereed en wordt nu getoetst in de klinische praktijk op o.a. werkbaarheid. De vorderingen van de ontwikkeling van het implementatieplan verlopen naar wens en zijn op schema.

Samenvatting van de aanvraag

Samenvatting
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Physical inactivity, referred to as a pandemic by the Lancet in 2012, has led to an increase in the prevalence of lifestyle-related chronic diseases on a global scale. Though life expectancy has increased, physical inactivity remains an impediment to healthy ageing: additional life years are often spent in illness. As such, there is a need for more awareness surrounding the preventive and curative role of physical activity and lifestyle in healthcare.

 

The prescription of physical activity and exercise in clinical care has been advocated worldwide through the ‘exercise is medicine (E=M)’ paradigm. Prescribing an active lifestyle and exercise as treatment options in clinical care can be used to prevent, treat, and oftentimes reverse lifestyle-related chronic diseases. However, E=M currently has no position in general routine hospital care, which is hypothesized to be due to attitudinal, and practical barriers to implementation.

 

This project aims to address challenges which clinicians face in the implementation of E=M, and create both greater awareness for E=M in a hospital setting, and create a tool to reduce practical barriers to enforcing E=M in hospital care. The E=M-tool will support the mutual decision making process between physician and patient, and will motivate patients to exercise and to adopt an active lifestyle.

 

The current project’s ultimate goal is to implement E=M into routine clinical care. It will do so by carrying out three objectives. Firstly, this project will perform qualitative research to study the current implementation status of E=M in clinical care as well as its facilitators and barriers to implementation among clinicians and hospital managers. Secondly, the project aims to develop an algorithm based on big data, which will result in tailored active lifestyle referral for patients. This algorithm will form the basis of an E=M-tool, which can be used by clinicians. Thirdly, the feasibility of implementing E=M in routine clinical care will be investigated, through carrying out pilot-studies which will integrate the tool in routine care in at least four clinical departments in two hospitals.

 

The PIE=M-project is highly innovative as it aims to introduce an unexplored effective treatment option in hospital care by means of the development and use of a novel E=M-tool, capable of constructing personalized physically active lifestyle options as part of clinical care, through the application of big data. As such, the project requires a newly established collaboration between data science and exercise science. Due to the handling of large data-sets throughout the study, the project will ensure findable, accessible, interoperable and re-usable data through enforcing FAIR data principles.

 

Furthermore, the PIE=M-project will set the stage as one of the first projects in the Netherlands to explore a tailored E=M prescription for patients. It is hypothesized that a tailored E=M prescription will lead to a higher active uptake of an active lifestyle by patients. Subsequently this will lead to lower rates of morbidity, a higher quality of life for patients, and reduced healthcare costs.

 

As the PIE=M-project involves the introduction of an unexplored innovative medical tool, extensive continuation of research activities are envisaged beyond the duration of the project. If the pilot implementation studies of the E=M-tool succeed, the PIE=M-project will form the basis for further efficacy studies at the level of the patient, in which health and fitness effects and cost-effectiveness of the implementation of E=M will be determined. Beyond the yielding of new knowledge and the introduction of an innovative tool to promote E=M, the diversity of the consortium of the E=M study will ensure an abundant dissemination of research findings and promotional materials for E=M. Involvement of the local ecosystem, for instance the municipality, local and nationwide sports organisations will ensure that the research can be diffused outside the hospital setting, for instance within community, and other settings.

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