scholarly journals Prescribing smartphone applications for physical activity promotion in primary care: modeling health gain and cost savings (Preprint)

Author(s):  
Leah Grout ◽  
Kendra Telfer ◽  
Nick Wilson ◽  
Christine Cleghorn ◽  
Anja Mizdrak
2014 ◽  
Vol 62 (2) ◽  

In addition to the delivery of primary care services, recent changes to the NHS in the United Kingdom have placed increasing responsibility on GPs for the commissioning of the full range of health services from prevention through to clinical interventions and rehabilitation. Whilst historically there has always been an expectation that primary care professionals were ideally placed to provide support for prevention as well as treatment, their active engagement in the promotion of physical activity has remained largely superficial. With notable exceptions where individuals have a personal interest or commitment, the majority of health professionals tend to limit themselves to peremptory non-specific advice at best, or frequently don’t broach the subject at all. There are a number of reasons for this including increasing time pressures, a general lack of knowledge, limited evidence and concerns about litigation in the event of an adverse exercise induced event. However in the 1990s there was a surge of interest in the emerging “Exercise on Prescription” model where patients could be referred to community based exercise instructors for a structured “prescription” of exercise in community leisure centres. Despite the continuing popularity of the model there remain problems particularly in getting the active support of health professionals who generally cite the same barriers as previously identified. In an attempt to overcome some of these problems Wales established a national exercise referral scheme with an associated randomised controlled trial. The scheme evaluated well and had subsequently evolved with new developments including integration with secondary and tertiary care pathways, accredited training for exercise instructors and exit routes into alternative community based exercise opportunities.


2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Jean-Pierre Laake ◽  
Joanna Fleming

Abstract Background Physical inactivity is the fourth leading risk factor for global mortality. Reducing sedentary behaviour and increasing physical activity are efficacious for improving many physical and mental health conditions including cardiovascular disease, type 2 diabetes and depression. Reducing sedentary behaviour and increasing physical activity can also be effective at reducing obesity; however, sedentary behaviour and reduced physical activity are also associated with mortality independently. Despite this, most adults in the UK do not currently meet the UK Chief Medical Officers’ guidelines for weekly physical activity. As most adults visit their general practitioner at least once a year, the primary care consultation provides a unique opportunity to deliver exercise referral or physical activity promotion interventions. This is a protocol for a systematic review of randomised controlled trials for the effectiveness of physical activity promotion and referral in primary care. Methods A comprehensive literature search of Embase, MEDLINE (Ovid), Web of Science (Core Collection), Scopus, CINAHL, PsycINFO, and The Cochrane Library (CENTRAL) will be conducted for studies with a minimum follow-up of 12 months that report physical activity as an outcome measure (by either self-report or objective measures) including an intention to treat analysis. The authors will screen papers, first by title and abstract and then by full text, independently assess studies for inclusion, appraise risk of bias and extract data. The quality of the evidence will be assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluations) approach. The primary outcome will be participation in physical activity at 12 months. Pooled effects will be calculated using random effects models. Results will be submitted for publication in a peer-reviewed journal and for presentation at UK national primary care conferences. Discussion This systematic review and meta-analyses will summarise the evidence for the effectiveness of physical activity promotion and referral as interventions for improving physical activity, as well as whether studies using objective measures of physical activity have similar effects to those studies using self-report measures. This knowledge has importance for primary care clinicians, patients and, given the focus of the recent NHS long-term plan on preventive medicine, those making policy decisions. Systematic review registration The protocol is registered with PROSPERO the international prospective register of systematic reviews, ID CRD42019130831


2010 ◽  
Vol 27 (3) ◽  
pp. 279-284 ◽  
Author(s):  
Z. Sabti ◽  
M. Handschin ◽  
M. K. Joss ◽  
E. Allenspach ◽  
M. Nuscheler ◽  
...  

2014 ◽  
Vol 62 (2) ◽  

The role of regular physical activity for population health has been clearly documented. Improvements in population levels of physical activity require long-term implementation of a combination of measures, including the evidence based approaches described in the “seven best investments for physical activity” (www.globalpa.org.uk): whole-of-school programmes, transport, urban planning, integration of physical activity promotion into primary health care systems, public education, community-wide programmes, sport for all. The health care setting has a particular role in this context, particularly in its access to physically inactive individuals. Switzerland has seen a number of successful research projects in this field, but there has been no wide adaptation of these approaches in the medical community. In recent years, a group of institutions including the Swiss College of Primary Care Medicine, the Policlinique Médicale Universitaire in Lausanne, the Ligue Vaudoise contre les Maladies Cardiovasculaires and the Institute of Social and Preventive Medicine of the University of Zurich have therefore focussed on the development of a physical activity counselling approach based on international evidence as well as on established tools, but streamlined to the specific demands of primary health care providers in Switzerland. PAPRICA (Physical Activity Promotion in Primary Care, www.paprica.ch) has been the result of these developments, and nearly 300 health professionals, most of them primary care physicians, have been successfully trained so far. PAPRICA is implemented together with the Swiss Society for Sports Medicine and a number of regional partners. The development of a national programme structure is currently under preparation. This will allow Switzerland to explore and better use the potential of physicians and other health professionals in the promotion of physical activity and in the fight against non-communicable diseases.


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