Article Text

The ‘miracle cure’: how do primary care physicians prescribe physical activity with the aim of improving clinical outcomes of chronic disease? A scoping review
  1. Jane Thornton1,
  2. Taniya Nagpal2,
  3. Kristen Reilly3,
  4. Moira Stewart3,
  5. Robert Petrella4
  1. 1Family Medicine, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada
  2. 2Department of Kinesiology, Brock University, Saint Catharines, Ontario, Canada
  3. 3Family Medicine, Western University, London, Ontario, Canada
  4. 4Department of Family Practice, The University of British Columbia Faculty of Medicine, Vancouver, Columbia, Canada
  1. Correspondence to Dr Jane Thornton; jane.s.thornton{at}


Objectives To identify how primary care physicians (PCPs) prescribe physical activity for patients with chronic disease, and to determine characteristics of physical activity interventions with improved clinical outcomes of chronic disease.

Design A scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews 2018 was completed.

Data sources Four bibliographic databases (Medline, EMBASE, SPORTDiscus, CINAHL) and four grey literature/unpublished databases (Proquest, National Institute for Health and Care Excellence, Canadian Health Research Collections, Clinical Trials) were searched from inception to 7 March 2022.

Eligibility criteria for selecting studies Studies involving PCP-delivered physical activity prescriptions or counselling for participants with a chronic disease or mental health condition, which reported clinical outcomes were included. Opinion papers, news and magazine articles and case reports were excluded, as were studies in which a physical activity intervention was provided for primary prevention of chronic disease, prescribed by healthcare providers or researchers other than PCPs, or for healthy participants without chronic disease.

Results An initial search identified 4992 records. Fifteen studies met inclusion criteria. Characteristics of physical activity prescriptions that improved clinical outcomes included: personalised advice; brief intervention; behavioural supports (handouts and/or referrals) and physician follow-up. Reported adverse events were rare. Research gaps include optimal timing and length of follow-up, and the long-term and cost-effectiveness of interventions.

Summary/Conclusion Several characteristics of physical activity counselling by PCPs for patients with chronic disease may improve clinical outcomes, although research gaps remain. Studies exploring the effectiveness of physical activity prescription for individuals with chronic conditions are urgently needed.

  • physical activity
  • exercise
  • physical activity promotion in primary care
  • non-communicable disease

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  • Contributors JT developed the idea and wrote the first draft. JT and TN conducted the search and evaluated the studies. RP acted as third reviewer when needed. KR and MS provided expertise in qualitative analysis. MS and RP provided study oversight. All authors were responsible in editing the manuscript and final approval of the submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests JT is an Editor of the British Journal of Sports Medicine.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.