Supervised Exercise Therapy for Intermittent Claudication Is Increasingly Endorsed by Dutch Vascular Surgeons

Area of Science:

• Vascular Surgery
• Rehabilitation Medicine
• Health Services Research

Background:

• Supervised exercise therapy (SET) is a recognized noninvasive treatment for intermittent claudication (IC).
• Initial hesitation among Dutch vascular surgeons regarding SET was noted in a 2011 survey.
• A nationwide network for SET was established in the Netherlands following the initial survey.

Purpose of the Study:

• To assess trends in Dutch vascular surgeons' perceptions of prescribing SET.
• To compare current views on SET prescription with data from a 2011 survey.
• To identify factors influencing SET adoption in IC management.

Main Methods:

• A 26-item questionnaire was administered to Dutch vascular surgeons, fellows, and senior residents in 2015.
• The questionnaire covered patient selection criteria, comorbidity considerations, and perceived barriers to SET.
• Results were compared with findings from a 2011 survey.

Main Results:

• The SET referral rate for new IC patients remained consistent (81% in 2015 vs. 75% in 2011).
• Willingness to prescribe SET increased significantly for IC patients with chronic obstructive pulmonary disease (86% vs. 69%).
• Fewer surgeons considered SET indicated for aortoiliac disease (63% vs. 76%), and reimbursement was identified as a major barrier.

Conclusions:

• Supervised exercise therapy is now widely accepted by Dutch vascular surgeons for intermittent claudication.
• SET use has increased for IC patients with cardiopulmonary comorbidities.
• Underutilization for aortoiliac disease persists, highlighting the critical role of insurance reimbursement for successful implementation.