Introducing physical activity to type 2 Diabetes Mellitus patients and those at risk: learning points from the Netherlands
TNO Kwaliteit van Leven
van Hespen, A.T.H.
Type 2 Diabetes Mellitus (DM) is one of the major diseases for which strong evidence exists that physical activity prevents onset and may counteract progress. However, it is not so easy to change physical activity behaviour in people that are usually inactive. As type 2 DM has a high incidence and prevalence in the Netherlands, it has been chosen as a priority for a national effort called "De Beweegkuur" (based on the idea of Exercise on prescription). It is known that tailored exercise counseling is most helpful. However, it will be more (cost) effective if only a few profiles exist in which patients could be divided and treated. The first aim was developing such patient profiles. The second aim was to get an impression of how "De Beweegkuur" meets the possibilities of general practitioners (GPs) and physiotherapists and how the profiles could be handled by them. Therefore a qualitative study was performed. Information from an internet literature search and some patient focus group interviews was used as basis for a consensus meeting to formulate criteria for patient profiles. Eleven GPs and 38 physiotherapists were interviewed about existing practices, attitudes, and barriers to change. Three different patient profiles were developed. GPs saw type 2 DM patients and those at risk four times a year on average. According to these GPs, barriers for patients to change their physical activity were: cost (programmes are not yet in health insurance), anxious to exercise because of fatigue, and overweight. Physiotherapists who deliver programmes complain that GPs are not very willing to prescribe physical activity and to let their patients join special programmes from "De Beweegkuur". It is recommended to use the newly developed patient profiles to make it easier for the GPs and physiotherapist s to divide patients in sub groups. This will enhance a more tailor-made guidance through the existing PA stimulating programme possibilities that are referred to "De Beweegkuur". Also, local cooperation between professionals should be improved.
To reference this document use:
Journal of Diabetology, 1 (1), 2