Exercise on prescription for women aged 40-74 recruited through primary care: two year randomised controlled trialBMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a2509 (Published 12 December 2008) Cite this as: BMJ 2008;337:a2509
- Beverley A Lawton, director1,
- Sally B Rose, research fellow1,
- C Raina Elley, senior lecturer 2,
- Anthony C Dowell, professor3,
- Anna Fenton, endocrinologist4,
- Simon A Moyes, biostatistician2
- 1Women’s Health Research Centre, Department of Primary Health Care and General Practice, PO Box 7343, University of Otago, Wellington, New Zealand
- 2Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Private Bag 92019, Auckland, New Zealand
- 3Department of Primary Health Care and General Practice, PO Box 7343, University of Otago, Wellington, New Zealand
- 4Christchurch Women’s Hospital, Christchurch, New Zealand
- Correspondence to: B Lawton
- Accepted 29 September 2008
Objective To assess the effectiveness of a primary care based programme of exercise on prescription among relatively inactive women over a two year period.
Design Randomised controlled trial.
Setting 17 primary care practices in Wellington, New Zealand
Participants 1089 women aged 40-74 not undertaking 30 minutes of moderate intensity physical activity on at least five days of the week
Intervention Brief physical activity intervention led by nurse with six month follow-up visit and monthly telephone support over nine months.
Main outcome measure Physical activity assessed at baseline and 12 and 24 months. Secondary outcomes were quality of life (SF-36), weight, waist circumference, blood pressure, concentrations of fasting serum lipids, glycated haemoglobin (HbA1c), glucose, insulin, and physical fitness.
Results Mean age was 58.9 (SD 7) years. Trial retention rates were 93% and 89% at 12 and 24 months, respectively. At baseline, 10% of intervention participants and 11% of control participants were achieving 150 minutes of at least moderate intensity physical activity a week. At 12 months rates increased to 43% and 30% and at 24 months to 39.3% and 32.8% (P<0.001), respectively. SF-36 physical functioning (P=0.03) and mental health (P<0.05) scores improved more in intervention compared with control participants, but role physical scores were significantly lower (P<0.01). There were no significant differences in clinical outcomes. More falls (P<0.001) and injuries (P=0.03) were recorded in the intervention group.
Conclusions This programme of exercise on prescription increased physical activity and quality of life over two years, although falls and injuries also increased. This finding supports the use of exercise on prescription programmes as part of population strategies to reduce physical inactivity.
Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) ANZCTRN012605000490673.
We thank the women who participated in this trial and the primary care practices from which participants were recruited.
Contributors: BAL was the principal investigator, conceived the study, and contributed to the study design and writing the paper. SBR, CRE, ACD, and AF were coinvestigators and all contributed to the study design. SBR was the project and data manager and performed preliminary data collation and formatting and contributed to writing the paper. CRE and SAM performed the data analyses and contributed to writing the paper. ACD and AF contributed to the interpretation of results and the final draft of the paper. All authors read and approved the final version of the manuscript. Data collection and entry were performed by Selina Brown, Rita Neve, Alice Paul, Jane Bowers, Esther Sweet, and Lucetta Reid. The Kapiti branch of Sport Wellington Region (Helene Kay) provided the telephone counselling to study participants. BAL is guarantor.
Funding: This work was supported by the National Heart Foundation of New Zealand (grant number 1091 and grant-in-aid numbers 1091 and 1222), the Lottery Health Research Grants Board, the Hutt Valley District Health Board, Sport and Recreation New Zealand, and the Maori Health Directorate (Ministry of Health).
Ethical approval: This work was approved by the Central Region Ethics Committee (formerly the Wellington Ethics Committee) in September 2004 (WGT/04/08/061). Participants gave written informed consent to participate in this study.
Competing interests: None declared.
Provenance and peer review: Not commissioned; externally peer reviewed.
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