Physician Practice Patterns and Barriers to Counselling on Physical Activity in Solid Organ Transplant Recipients: A Canadian Survey

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Abstract

Introduction

Many solid organ transplant (SOT) recipients fail to meet the recommendations for population-based physical activity (PA) levels. “Physician recommendation” has previously been reported by SOT recipients as a key facilitator to being more physically active. The purpose of this study was to determine the proportion of Canadian SOT physicians providing PA counselling and identify barriers to including such counselling as part of the SOT recipients’ routine care.

Material and Methods

We conducted a cross-sectional, web-based survey study to evaluate physicians’ PA counselling practices, including the prevalence and barriers to such practice. Investigators developed a 21-item questionnaire which was composed of 6 subsections: A) Pre-questionnaire eligibility (1 item); B) Consent (1 item); C) Demographics (6 items); D) Knowledge about physical activity (6 items); E) Physical activity counselling and potential barriers (5 items); and F) Future considerations (2 items). A survey link was sent to a convenience sample of transplant physicians who are members of the Canadian Society of Transplantation.

Results and Discussion

Thirty-four physicians (13.6%) participated in the survey. The majority of the respondents worked with kidney (65%; n=22), liver (32%; n=11), or pancreas (29%; n=10) organ groups. While 97% (n=33) of the participants reported providing PA counselling to their transplant patients, only 27% provided PA counselling to all their patients and only 18% (n=6) responded they were very confident in PA counselling. The main barriers reported by SOT physicians to PA counselling were lack of time (n=19; 56%) and exercise guidelines (n=18, 53%), followed by lack of confidence (n=8; 23%), research evidence (n=7; 20%) and knowledge about exercise (n=7; 20%).

Conclusions

Increasing educational opportunities for physicians to learn about PA and exercise, developing specific PA guidelines for SOT as well as establishing a referral system to exercise specialists might improve the frequency and quality of PA counselling post-transplant.

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