Exercise on prescription in general practice: a systematic review

Area of Science:

• Public Health
• Preventive Medicine
• Health Technology Assessment

Background:

• Lifestyle diseases are a growing concern, necessitating effective interventions in primary healthcare.
• Exercise on Prescription (EoP) is a personalized secondary prevention strategy to increase physical activity in sedentary individuals.
• Primary healthcare settings are key for implementing lifestyle interventions.

Purpose of the Study:

• To assess the effectiveness of EoP in improving physical activity and fitness.
• To evaluate the acceptability and feasibility of EoP for general practitioners (GPs) and patients.
• To determine the cost-effectiveness of EoP and identify research gaps.

Main Methods:

• A systematic review of 22 studies was conducted.
• Searches included Medline, reference lists, and NLM Gateway.
• The review adopted a Health Technology Assessment perspective.

Main Results:

• EoP showed moderate improvements in physical activity (10% increase vs. controls) and aerobic fitness (5-10% increase) over 6-12 months.
• EoP was found to be acceptable and feasible for GPs and patients who volunteered.
• Limited evidence supports more intensive EoP being more effective; cost-effectiveness was suggested but not compared to other interventions.

Conclusions:

• EoP demonstrates potential for improving physical activity and fitness in targeted populations.
• While feasible for motivated participants, understanding barriers for non-completers and non-motivated individuals is crucial.
• High-quality research is needed to evaluate sustainable EoP schemes in routine general practice.