MedExUL: A community-based interdisciplinary approach to chronic illness rehabilitation; protocol for qualitative study of attenders and defaulters

Problem

Insufficient physical activity (PA) is one of the leading risk factors for premature death worldwide.

Globally, 6-10% of IHD, stroke, diabetes, and some cancers occur due to lack of PA.

A way of addressing this challenge is through exercise referral. The Health Service Executive (HSE) National Exercise Referral Framework (NERF) aims to increase PA levels and improve health in individuals living with an established non-communicable disease (NCD) or mental illness. The medical exercise programme in University of Limerick (MedEx UL) is one such NERF centre. We describe the initial 15 month experience of running the programme.

Many patients who would clearly benefit from the programme also stop attending. Their reasons for defaulting have not been studied in detail in the past. This has clear implications for the future design and delivery of the programme.

Approach

The aim of this study is to evaluate the patients’ experience of MedEx UL through one-to-one semi structured and focus group interviews with (i) patients who have sustained participation over a 6-month period and (ii) with people who have dropped out of the program.

A semi-structured interview script is being developed, informed by the theory of planned behaviour to assess patient experience of MedEx UL. This script will be used to conduct one on one (1-1) interviews with MedEx UL patients.

Findings

The patients’ values, beliefs, motivation to comply and subjective social norms, along with their programme expectations and how these change over a 6-month timeframe will be studied.

Secondary outcome measures will include daily minutes of moderate to vigorous physical activity, as well as details of their physical health and quality of life.

As the programme is still in the planning stage we have no results to report as yet.

Consequences

Our primary goal is to understand the patients’ experience of MedEx UL, and with this knowledge, recommend how the services at other NERF centres can be improved to achieve desired outcomes. This study will also provide novel information as no other MedEx group has studied this aspect of patients’ experience of the program.