Exercise on prescription for women aged 40-74 recruited through primary care: two year randomised controlled trial.

Description

In this study, 1,089 relatively inactive women aged 40-74 years were randomly assigned to a primary care-based program of exercise or to a control group to test the effectiveness and sustainability of a primary care-based program of exercise prescribed for two years. The intervention consisted of brief motivational interviewing techniques to increase physical activity together with telephone calls over a nine-month period and an added 30 minutes of visit with the primary care nurse at six months. Control participants received usual care from their primary care practice. Retention rates were 93% and 89% at 12 months and 24 months, respectively. Both groups increased their physical activity level during the 24-month study period. At 12 months, mean physical activity levels (p=0.01) and the proportion of women achieving the target of 150 minutes of at least moderate intensity physical activity were higher in women in the intervention group (43%) than in women in the control (30%) group (p<0.001). At 24 months, although still significant, proportions were 39% and 33% in the intervention group and control group, respectively. Quality of life and mental health scores improved more in the intervention group but falls and injuries were also more frequent in this group. No significant benefits were achieved in clinical outcomes (weight, waist circumference, lipid profile, systolic and diastolic blood pressure). This paper was accompanied by an editorial (BMJ 2008;337:a2430) that recognized that the health benefits generated by exercise training are so great that it is probably the most important self-help treatment available so far. The editorial’s authors emphasized the fact that the study by Lawton et al. demonstrated that exercise promotion in primary care is feasible and sustainable for at least two years. To reach this objective through general practice, behaviour changes should be embedded in routine care, based on continuing contact and dialogue and obviously tailored to individual needs and interests. The editorial concluded by mentioning that the next research step is to improve the management program to prevent falls and injuries.