University of Manchester, UK.
Ann R Coll Surg Engl. 2022 Feb;104(2):130-137. doi: 10.1308/rcsann.2021.0221. Epub 2022 Jan 4.
To determine the current (pre-COVID-19) provision of supervised exercise training (SET) for patients with peripheral arterial disease (PAD) in UK Vascular Centres.
Hospital Trusts delivering vascular care to patients with PAD were identified from the National Vascular Registry and asked to complete an online questionnaire on their provisions for SET. If a centre offered SET, they were asked questions to determine whether the programme was compliant with NICE guidelines and the difficulties they faced delivering the service. If centres did not offer SET, they were asked what obstacles prevented them implement SET.
Of the 78 UK vascular centres, 59 (76%) responded and were included in the audit. Of these, 27 (46%) were able to offer SET but only 21 (36%) could offer it to all their patients with PAD. Only four (6.8%) offered SET that was fully compliant with current NICE guidelines. Reasons identified included insufficient funding, lack of resource and poor patient compliance.
The benefits of SET are well established yet the availability of the service in the UK is poor. The reasons for this are readily identified but have not yet been overcome. Research on novel methods of delivering supervised exercise that mitigates existing barriers, such as home exercise with remote monitoring, should be prioritised to facilitate optimal management for our patients with PAD.
为了确定英国血管中心目前(COVID-19 之前)为外周动脉疾病(PAD)患者提供的监督性运动训练(SET)。
从国家血管登记处确定为 PAD 患者提供血管护理的医院信托,并要求他们在线回答有关 SET 规定的问题。如果中心提供 SET,则会询问他们的方案是否符合 NICE 指南以及提供服务所面临的困难。如果中心不提供 SET,则会询问是什么障碍阻止他们实施 SET。
在 78 个英国血管中心中,有 59 个(76%)做出了回应并被纳入审计。其中,27 个(46%)能够提供 SET,但只有 21 个(36%)能够为所有 PAD 患者提供 SET。只有 4 个(6.8%)提供了完全符合当前 NICE 指南的 SET。确定的原因包括资金不足、资源匮乏和患者依从性差。
SET 的益处已得到充分证实,但该服务在英国的可用性很差。造成这种情况的原因很容易识别,但尚未得到解决。应该优先研究通过远程监测的家庭运动等新方法来提供监督性运动,以促进我们的 PAD 患者的最佳管理。