Primary care physical activity interventions increase time spent in moderate to vigorous physical activity

By Melanie Hinze
New research offers GPs and other health practitioners yet another compelling reason to make physical activity counsel­ling a standard part of their care, an Australian expert told Medicine Today.

Professor Emmanuel Stamatakis, Professor of Physi­cal Activity, Lifestyle, and Population Health at the Charles Perkins Centre and Faculty of Health Sciences, The University of Sydney, said, ‘Relatively simple interventions such as regularly repeated advice could increase the percentage of patients meeting the current physical activity recommendations by 33%.’

Published in The BMJ, the systematic review and meta­ analysis of 46 randomised controlled trials, involved 16,198 participants who were followed for between three and 60 months. The trials compared aerobic based physical activity interventions delivered or prompted by health professionals in primary care, with control groups consisting of usual care or another control that did not involve physical activity.

Most studies were conducted in the US, the UK, Netherlands or Spain, with the interventions most often conducted by GPs, nurses or physiotherapists. Half the interventions studied involved multiple, brief sessions; 18 were intensive interventions; and 10 were brief. Twenty­-three studies involved fewer than five contacts with healthcare professional, whereas the remainder involved five or more contacts.

Physical activity interven­tions delivered or prompted by health professionals in primary care increased the odds of patients meeting guidelines for moderate to vigorous intensity physical activity (MVPA) by 33% compared with controls. These inter­ventions also increased MVPA by 14 minutes/week.

When the authors limited their results to trials that used a device to measure physical activity, no significant difference in MVPA was noted between groups. However, trials that used self­-report measures showed that participants achieved 24 minutes/week more MVPA than controls.

The intensity of the interven­tion was not found to impact minutes/week of MVPA; however, interventions with five or more contacts had a larger effect than those with fewer contacts.

The authors concluded that physical activity interventions delivered or prompted by health professionals in primary care appeared to be effective at increasing participation in self­-reported MVPA.

‘This is an extremely encouraging finding that highlights the huge potential healthcare systems have in assisting the population to improve their lifestyles and prevent or delay the onset of chronic disease,’ Professor Stamatakis said.
BMJ 2022; 376: e068465.