“Some exercise is good, more is better,” say medical chiefs in new guidanceBMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l5470 (Published 07 September 2019) Cite this as: BMJ 2019;366:l5470
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These guidelines provide health professionals with evidence based knowledge they can trust when counselling patients about ways to optimise their health and prevent disease in the future. The next step in this process is encouraging and supporting staff to deliver these messages to patients.
Brief interventions to encourage exercise amongst patients have been shown to be both cost effective (1) and successful; the number needed to treat for one additional sedentary adult to be meeting recommended exercise levels at 12 months is just 12 (2). This is in comparison to brief interventions for smoking cessation where the estimated number needed to treat is between 50 and 120 (3).
Given that brief interventions are a cheap and effective way to encourage exercise in the population, we should be seeing these delivered in a variety of settings to a large number of patients. However, barriers including limited options for referring patients, low confidence in services and poor knowledge, with little to no inclusion of the subject in medical school curriculums (4), mean this is currently not the case.
We must do more to encourage healthcare professionals to incorporate exercise advice into their interactions with patients, starting with adding exercise medicine into medical school curriculums and improving and expanding exercise prescriptions schemes. If GPs discuss exercise with every patient they see, it is likely that at least one every day would be exercising regularly at 12 months. Add to that the number of patients seen in hospitals, clinics and other healthcare settings each day and a quick, simple intervention could lead to a big impact on population health.
1. GC V, Wilson ECF, Suhrcke M, Hardeman W, Sutton S, VBI Programme Team. Are brief interventions to increase physical activity cost-effective? A systematic review. Br J Sports Med [Internet]. BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine; 2016 Apr 1 [cited 2019 Sep 7];50(7):408–17. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26438429
2. Orrow G, Kinmonth A-L, Sanderson S, Sutton S. Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials. BMJ [Internet]. British Medical Journal Publishing Group; 2012 Mar 26 [cited 2019 Sep 7];344:e1389. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22451477
3. Stead LF, Bergson G, Lancaster T. Physician advice for smoking cessation. In: Stead LF, editor. Cochrane Database of Systematic Reviews [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2008 [cited 2019 Sep 7]. p. CD000165. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18425860
4. Seth A. Exercise prescription: what does it mean for primary care? Br J Gen Pract [Internet]. Royal College of General Practitioners; 2014 Jan [cited 2019 Sep 7];64(618):12–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24567552
Competing interests: No competing interests