Overview of studies of exercise prescription in general practice since 2010 (n=23)
| Author, year Study type, location | Title | Main components and outcomes |
| Petrella et al, 2010 RCT, Canada28 | Improving aerobic fitness in older adults; effects of a physician-based exercise counselling and prescription program | Both intervention and control group showed improvements in PA levels compared with baseline, but there were no statistically significant differences between the two. |
| Leijon et al, 2010 Observational, Sweden34 | Factors associated with patients self-reported adherence to prescribed physical activity in routine primary health care | Adherence to EP was 56% at 3 months and 50% at 12 months. Higher baseline PA levels and prescriptions that included home-based activities are associated with higher adherence. |
| Persson et al, 2010 Observational study, Sweden35 | Simplified routines in prescribing physical activity can increase the amount of prescriptions by doctors, more than economic incentives only: an observational intervention study | Incorporating a referral system into EP whereby the GP involves other professionals in the patient’s care increases the amount of EP. |
| Carroll et al, 2010 RCT, USA29 | Computerized tailored physical activity reports A randomized controlled trial | An individually tailored PA programme increased PA compared with baseline at 6 months, but there was no significant difference to the control group. |
| Elley et al, 2011 Observational, New Zealand36 | Cost-effectiveness of exercise on prescription with telephone support among women in general practice over 2 years | An intervention involving EP and telephone support from practice nurses can move people from less active to more active categories over 24 months and is cost effective. |
| Patel et al, 2011 Interviews, New Zealand47 | General practitioners' views and experiences of counselling for physical activity through the New Zealand green prescription program | Generally, GPs were well disposed to EP. Strategies to save time included collaborating with dedicated exercise support counsellors and involving practice nurses. |
| Attalin et al, 2012 Survey, France37 | Physical -activity prescription for obesity management in primary care: attitudes and practices of GPs in a southern French City | The majority of GPs had no training in EP. Lack of available validated tools followed by lack of time were the most important barriers for GPs. |
| Persson et al, 2013 Focus groups, Sweden48 | Physical activity on prescription (PAP) from the General Practitioner’s perspective – a qualitative study | Asking and advising about PA was considered acceptable and important but taking the extra step of prescribing it was not. GPs preferred to refer for EP. |
| Knight et al, 2014 RCT, Canada30 | Prescribing physical activity through primary care: does activity intensity matter? | EP at different intensities improved cardiometabolic health markers. |
| Knight et al, 2014 Trial (non-randomised), Canada31 | Health promotion through primary care: enhancing self-management with activity prescription and mHealth | EP plus remote monitoring technologies improved physiological outcomes and PA levels in groups that targeted sedentary behaviour, higher intensity PA and both. |
| Knight and Petrella, 2014 Mixed-method, Canada50 | Prescribing physical activity for healthy aging: longitudinal follow-up and mixed method analysis of a primary care intervention | Physiological gains were maintained at 6 months. Participants reported that mHealth is an acceptable support. |
| Windt et al, 2015 Pre-test and post-test, Canada38 | Can a 3-hour educational workshop and the provision of practical tools encourage family physicians to prescribe physical activity as medicine? A pre-post study | The proportion of GPs who reported EP activity rose significantly (p<0.5). |
| Lanhers et al, 2015 Cross-sectional survey, France39 | General practitioners’ barriers to prescribe physical activity: the dark side of the cluster effects on the physical activity of their type 2 diabetes patients | Patients that had lower perceived barriers to PA had better PA levels and better glycaemic control. GPs who perceived higher barriers to PA promotion tended to have patients who did less PA. |
| Arciniegas Calle et al, 2016 Pre-test and post-test, South America40 | One-day workshop-based training improves physical activity prescription knowledge in Latin American physicians: a pre-test post-test study | Significant improvement in knowledge gain (p<0.001) was reported for doctors who attended a 1-day workshop on EP. |
| Joelsson et al, 2018 Focus group, Sweden49 | Patients with chronic pain may need extra support when prescribed physical activity in primary care: a qualitative study | Participants reported lack of clarity about the nature and practical implementation of EP. |
| Lundqvist et al, 2017 Observational, Sweden41 | Physical activity on prescription (PAP), in patients with metabolic risk factors. A 6-month follow-up study in primary health care | EP was delivered by practice nurses mainly, including 1–2 support sessions during the 6 months. 73% of patients had improved PA levels at 6 months. |
| Rodjer et al, 2016 Observational, Sweden42 | Physical activity on prescription (PAP): self-reported physical activity and quality of life in a Swedish primary care population, 2-year follow-up | The intervention involved a written EP and follow-up with an exercise professional. Significant improvements in PA were noted at 6 months and 12 months but not at 2-year follow-up. |
| Harris et al, 2018 RCT, England32 | A pedometer-based walking intervention in 45- to 75-year-olds, with and without practice nurse support: the PACE-UP three-arm cluster RCT | Intervention with pedometer plus nurse or postal support improved PA levels significantly. The improvement was maintained at 3 years. |
| Fowles et al, 2018 Survey, Canada43 | Exercise in medicine Canada physical activity counselling and exercise prescription training improves counselling, prescription, and referral practices among physicians across Canada | After a full training day, confidence was improved and barriers were overcome. At 3-month follow-up, physicians prescribing EP went from 20% to 74%. |
| O’Brien et al, 2018 Survey, Canada44 | The effects of previous educational training on physical activity counselling and exercise prescription practices among physicians across Nova Scotia: a cross-sectional study | Physicians who had received training in PA counselling and PA prescription were more likely than physicians who had never attended, to advise their patients about PA. |
| Yaman and Atay, 2018 RCT, England33 | The effect of exercise prescription of primary care physician on the quality of life in patients | Patients who received an EP reported better quality of life and had objectively measured physical function. The EP contained endurance, strength, balance and flexibility components. |
| Smith et al, 2018 Observational, Australia45 | Prescription of physical activity in management of high blood pressure in Australian general practices | Most patients did not receive an EP. Those that did were more likely to engage and to consider PA to be important. |
| Lundqvist et al, 2019 Observational Sweden46 | Which patients benefit from physical activity on prescription (PAP)? A prospective observational analysis of factors that predict increased physical activity | The most common EP was 30–45 min of moderate-intensity walking, 2–5 days per week. Physical and psychological factors were associated with better EP uptake. |
EP, exercise prescription; GP, general practitioner; PA, physical activity; RCT, randomised control trial.