Exercise in Medicine in Russia
Noncommunicable diseases, mainly cardiovascular diseases and cancers, and external causes account for more than 80% of mortality in Russia. The leading causes of death and disability are directly associated with behavioural risk factors, physical inactivity being one of them. Until a few years ago, a clear standard recommendation on physical activity (PA) counselling for general practitioners did not exist in Russia. In 2010, the guidelines on physical activity counselling for primary health care providers were developed. On the basis of these guidelines the national recommendations on PA were developed in 2011. They were included in the national recommendations on Cardiovascular Prevention of the Society of Cardiology of the Russian Federation. In 2012 the guidelines were adopted by the Ministry of Health of the Russian Federation and recommended to primary health care providers of all Russian regions. One of the reasons why primary health care providers are not involved enough in counselling their patient regarding a healthy lifestyle – PA as well as smoking, healthy nutrition or other habits – is that these consultations are not covered by health insurance companies. Other barriers are the absence of the topic of a healthy life-style in pre-graduate and post-graduate curricula of medical universities as well as limited counselling skills in physicians. In 2011 an educational training course for primary health providers based on the guidelines described above was established by the National Research Centre for Preventive Medicine. The further implementation of the PA recommendations depends on the one hand on their inclusion in the curricula of medical universities and on the other hand on the creation of ways for involving and motivating primary health care providers to counsel patients in this area.