Prescribing Exercise for Cardiac Patients: Knowledge, Practices, and Needs of Family Physicians and Specialists

Purpose: To determine the following about prescribing exercise for cardiac patients: physicians' present and needed knowledge; their present practices; barriers that hinder them; and perceived need for and content of a protocol for prescribing exercise.

Methods: (1) Questionnaire mailed to 371 family physicians (FPs), 31 internists, and 25 cardiologists; and (2) four focus groups consisting of 25 FPs, 1 internist, and 3 cardiologists.

Results: Questionnaire response rate was 45% (n = 192). Because responses were similar and the group was small, internists and cardiologists were combined as "specialists." Generally, questionnaire data agreed with focus group data, with the latter providing more detail. Family physicians perceived they know little about prescribing a specific exercise program while specialists perceived they know little about motivating patients to begin an exercise program. The method most frequently used by both physician groups to increase exercise is providing general advice. The main barriers to prescribing exercise were inadequate knowledge (FPs only), patient education materials, and community resources. Both groups rated highly the need for a protocol for prescribing exercise and indicated it should: (1) include identification of patient's stage of change; (2) include indications and contraindications for exercise; (3) provide guidelines for developing a specific exercise prescription; (4) contain patient education materials, and (5) be simple and short.

Conclusions: Family physicians perceive they know little about prescribing a specific exercise program for cardiac patients while specialists perceive they know little about motivating patients. Physicians rate highly the need for a protocol to help them prescribe exercise for cardiac patients.