 |
|
Effectiveness of Physical Activity Advice and Prescription by Physicians in Routine Primary CareA Cluster Randomized Trial
Gonzalo Grandes, MD, MS;
Alvaro Sanchez, PhD;
Ricardo Ortega Sanchez-Pinilla, MD;
Jesus Torcal, MD;
Imanol Montoya, MS;
Kepa Lizarraga, MD;
Javier Serra, MD; for the PEPAF Group
Arch Intern Med. 2009;169(7):694-701.
Background Physical activity promotion is a priority, but contribution of physicians' interventions is unclear. The effectiveness of the PEPAF ("Experimental Program for Physical Activity Promotion"), which was implemented exclusively by physicians in routine primary care from October 2003 to December 2004, was assessed.
Methods Fifty-six Spanish family physicians were randomized to either the intervention (n = 29) or standard care (n = 27) arm of the trial. The physicians recruited 4317 physically inactive patients (2248 for intervention and 2069 for control protocols) from a systematic sample after assessing their physical activity in routine practice. Intervention physicians provided advice to all patients and a physical activity prescription to the subgroup attending an additional appointment (30%). The main outcome measure was the change in physical activity measured by blinded nurses using the 7-Day Physical Activity Recall. Secondary outcomes included cardiorespiratory fitness and health-related quality of life.
Results At 6 months, intervention patients increased physical activity more than controls (adjusted difference, 18 min/wk [95% confidence interval, 6-31 min/wk]; metabolic equivalent tasks x hours per week, 1.3 [95% CI, 0.4-2.2]). The proportion of the population achieving minimal physical activity recommendations was 3.9% higher in the intervention group (1.2%-6.9%; number needed to treat, 26). No differences were found in secondary outcomes. The effect of intervention was positively modified in subjects older than 50 years (P  .01) and in the prescription subgroup (P < .001).
Conclusions Family physicians were effective for increasing physical activity of primary care patients. Overall clinical effect was small but relevant for population public health. Within the intervention program, clinically relevant effects were seen in patients receiving a physical activity prescription.
Trial Registration clinicaltrials.gov Identifier: NCT00131079
Author Affiliations: Primary Care Research Unit of Bizkaia, Basque Health Service–Osakidetza (BHS), Bilbao, Spain (Drs Grandes and Sanchez and Mr Montoya); Santa Barbara Primary Care Center, Castilla–La Mancha Health Service, Toledo, Spain (Dr Ortega Sanchez-Pinilla); Basauri–Ariz Primary Care Center, BHS, Basauri, Spain (Dr Torcal); and Sports Medicine Service of the Provincial Government of Bizkaia, Bilbao (Drs Lizarraga and Serra).
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLE
In This Issue of Archives of Internal Medicine
Arch Intern Med. 2009;169(7):648.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Diabetes and Physical Activity
The Diabetes Educator 2012;38:129-132.
FULL TEXT
Determining levels of physical activity in attending physicians, resident and fellow physicians and medical students in the USA
Stanford et al.
Br. J. Sports. Med. 2011;0:bjsports-2011-090299v1-bjsports-2011-090299.
ABSTRACT
| FULL TEXT
Monitoring Healthy People 2010 Arthritis Management Objectives: Education and Clinician Counseling for Weight Loss and Exercise
Do et al.
Ann Fam Med 2011;9:136-141.
ABSTRACT
| FULL TEXT
Physical activity as medicine: time to translate evidence into clinical practice
Hellenius and Sundberg
Br. J. Sports. Med. 2011;45:158-158.
FULL TEXT
Physicians promoting physical activity using pedometers and community partnerships: a real world trial
Trinh et al.
Br. J. Sports. Med. 2011;0:bjsm.2009.069567v1-bjsports069567.
ABSTRACT
| FULL TEXT
Behavioral Counseling to Promote Physical Activity and a Healthful Diet to Prevent Cardiovascular Disease in Adults: A Systematic Review for the U.S. Preventive Services Task Force
Lin et al.
ANN INTERN MED 2010;153:736-750.
ABSTRACT
| FULL TEXT
Quality of Life and Cost-effectiveness of a 3-Year Trial of Lifestyle Intervention in Primary Health Care
Eriksson et al.
Arch Intern Med 2010;170:1470-1479.
ABSTRACT
| FULL TEXT
ACCF/AHA 2009 Performance Measures for Primary Prevention of Cardiovascular Disease in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Performance Measures for Primary Prevention of Cardiovascular Disease) Developed in Collaboration With the American Academy of Family Physicians; American Association of Cardiovascular and Pulmonary Rehabilitation; and Preventive Cardiovascular Nurses Association Endorsed by the American College of Preventive Medicine, American College of Sports Medicine, and Society for Women's Health Research
Redberg et al.
J Am Coll Cardiol 2009;54:1364-1405.
FULL TEXT
AHA/ACCF 2009 Performance Measures for Primary Prevention of Cardiovascular Disease in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Performance Measures for Primary Prevention of Cardiovascular Disease): Developed in Collaboration With the American Academy of Family Physicians; American Association of Cardiovascular and Pulmonary Rehabilitation; and Preventive Cardiovascular Nurses Association
WRITING COMMITTEE MEMBERS et al.
Circulation 2009;120:1296-1336.
FULL TEXT
Physical Activity Advice from Primary Care Physicians
Journal Watch Cardiology 2009;2009:5-5.
FULL TEXT
|
