Tew, Garry ORCID: https://orcid.org/0000-0002-8610-0613, Sharpe, Lisa, Abbas, Asim, Bond, Martin, Jordan, Alastair ORCID: https://orcid.org/0000-0002-7669-4753, Ross, Hannah, Hex, Nick, MacDonald, Rachael and Thompson, Andrew (2025) Implementation and evaluation of a supervised exercise programme for people with claudication in York, England. Journal of Vascular Nursing. (In Press)

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Abstract

Background

Supervised exercise therapy (SET) has been shown to improve claudication symptoms in patients with peripheral artery disease (PAD), and it is recommended as a first-line treatment in national and international guidelines. Despite this, supervised exercise programmes have not been widely implemented in many countries. This quality improvement project aimed to implement and evaluate an exercise service for people with claudication in York, England.

Methods

The York Claudication Exercise Service was launched in October 2023. Eligible patients were referred from vascular clinics at York Hospital. The service provided each participant with two, 1-hour exercise sessions per week over a 12-week programme. Standardised assessments were performed before and after the programme. Routinely assessed outcomes (e.g., recruitment, attendance, satisfaction, and treadmill walking distances) were used to evaluate the service over the first 12 months. Descriptive statistics were used to explore feasibility, acceptability, fidelity, and preliminary effects. A cost-comparison analysis was also conducted before and after the exercise service was implemented.

Results

By May 2024, 65 eligible patients had been referred, with 29 patients (44.6 %) commencing the exercise sessions. The exercise programme was delivered as intended and the median number of sessions attended was 19 (out of 24). At service exit, 13 (59.1 %) out of 22 participants reported an improvement in their claudication symptoms and were discharged to primary care. The mean (95 % CI) increase in pain-free walking distance was 110 m (39 to 182). All but one participant rated the service as ‘good’ or ‘excellent’. Economic modelling estimated that the programme would result in an annual cost-saving of £223.21 per person, or £366.40 per person using estimated costs for a future delivery model.

Conclusions

The service was successfully implemented within the existing care pathway. The evaluation indicated a high level of patient satisfaction, improvement in claudication symptoms and prevention of unnecessary referrals for vascular imaging and revascularisation. Agreements have been obtained to continue the service for at least 2 more years. During this period, sustainability funding will be sought, and the service will be adapted to improve access and uptake.

Item Type:	Article
Status:	In Press
DOI:	10.1016/j.jvn.2025.07.002
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine R Medicine > RM Therapeutics. Pharmacology > RM695 Physical therapy. Occupational therapy
School/Department:	School of Science, Technology and Health
Institutes:	Institute for Health and Care Improvement
URI:	https://ray.yorksj.ac.uk/id/eprint/12295

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