GP attitudes towards the prescription of physical activity as a preventative medicine
Introduction
Despite decades of scientific research, there remains a lack of understanding around how to effectively promote physical activity for health. As well as this, it is also evident that there is a lack of awareness regarding digital interventions that are designed to support individuals to improve their physical activity habits. Current physical activity advice from general practitioners (GPs) tends to be generic with little consideration for personal preferences – often focussing on exercise-based initiatives such as the ‘Parkrun Race’ and ‘Couch to 5K.’ These schemes certainly do not appeal to everyone, so it is no wonder that most people struggle to act on the physical activity advice they receive from their GP. As such, there is an urgent requirement for interconnected thinking in primary care that appropriately considers digital solutions to increase population-wide physical activity levels.
Physical Activity and GPs
Physical activity contributes to the prevention and management of many chronic health conditions. Primary care practitioners have a key role to play in supporting people to improve their physical activity levels, so we can reap the population health benefits as a nation. Physical inactivity rates in the UK are among the highest worldwide and is associated with 1 in 6 deaths. Around 39% of UK adults do not meet the recommended physical activity guidance (BHF, 2017).
The average person sees their GP more than 5 times per year, and around half of these visits are related to long-term health conditions. Physical activity is extensively proven to play a key role in managing many of these health conditions and therefore can promote better health on a population level if it were to be prescribed appropriately in a primary care setting. GPs have unique access to local communities and can reach those experiencing ill health from many different sub-populations, including those of a lower socio-economic status and those with protected characteristics. This puts them in a strong position to support a huge variety of individuals to improve their health, with physical activity prescription available as a powerful tool to improve health outcomes and reduce our reliance on medications and other prescribed pharmacological treatments.
The study
A recent study, explored the awareness and knowledge that primary care GPs have regarding the general physical activity guidelines, as well as their confidence to promote physical activity to their patients. The findings from this study are very interesting. Most GP responders (98.9%) believed that physical activity was important, yet only 35.7% reported being ‘somewhat familiar’ with the current physical activity guidelines.
Despite this, 74.1% of GPs felt confident to raise the topic of physical activity with their patients. This may be due to the fact they are familiar with the two well-known initiatives that are widely used in England: ‘Couch to 5K’ and the ‘Parkrun Race’. Therefore, it is clear that physical activity can indeed be prescribed by GPs and employed as a powerful tool to improve population health. However, the issue lies with the type of physical activity that they prescribe, as it may only be suitable for a small percentage of the population.
These common initiatives are unlikely to appeal to the majority of the population due to their strong focus on exercise. As a subset of physical activity, structured exercise has many well-known barriers to participation, such as a lack of time, perceptions of patient attitude and risk, and access to the necessary equipment, such as appropriate footwear. It is clear then that such interventions are only appealing to a small percentage of the population, which are likely to be a completely different demographic to those who are seeking physical activity advice from their GP. For example, someone who has the motivation and facilitators to go and participate in a Parkrun Race is most likely someone who is already in a good position to increase their physical activity. For those who do try to act on the advice of their GP with little thought for how to build their fitness appropriately have a high chance of being burnt out quickly and/or suffering an injury, and therefore drift back to a more sedentary lifestyle.
If these initiatives are portrayed as the only options for individuals living with long-term health conditions or those who are facing other barriers to becoming more active, they may decide that physical activity is simply not for them as they feel they are unable to take part, or simply do not have enough time to fit structured exercise into their daily routine. It is absolutely vital that other options are made available to support them to improve their level of physical activity. This can start by encouraging GPs to improve their knowledge and understanding of physical activity and how it can best be recommended for better health. In doing so, they will become more comfortable when recommending evidence-based digital tools designed to help patients improve their activity levels, and subsequently more patients will be made aware that the health benefits of regular physical activity can be made accessible, attainable and appealing for all.
KiActiv®
At KiActiv®, we use patented technology to help you develop a personalised understanding of your everyday physical activity. Our technology-enabled digital service integrates accurate on-body data from a wearable device with a suite of easy-to-use online tools and the support of a personal KiActiv® Mentor to guide you to make simple but meaningful changes to your daily routine that can be sustained to benefit your long-term health. Rather than simply prescribing you a ‘Parkrun’, we help you build an awareness of your everyday movement across multiple dimensions of physical activity, all of which carry independent physiological benefits for health. This approach to physical activity has proven both accessible and appealing to much wider audience and therefore represents a good option for physical activity promotion at a population-level.
Conclusion
In conclusion, GPs clearly value the incredible health benefits of physical activity, yet barriers still exist to embedding its promotion into primary care. It has been recorded that 1 in 4 people would be more physically active if advised to by a GP, so firstly this must occur, but secondly, they must have the understanding and awareness to prescribe the most appropriate interventions for each individual.
To take steps towards an effective solution and improve the accessibility of physical activity for all, GPs must be made to feel comfortable and well-informed when discussing the array of options available for patients to improve their physical activity and benefit their health. Encouraging a more personalised approach that utilises the array of digital tools on offer – such as KiActiv® Health – rather than making blanket recommendations centred on exercise-based interventions will undoubtedly increase uptake, improve the prevention and management of long-term health conditions, and get as many people as possible moving more to benefit their health.
