Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis.

Toby Pavey, Adrian Taylor, Kenneth Fox, Melvyn Hillsdon, Nana Anokye, John Campbell, Colin Green, Tiffany Moxham, Nanette Mutrie, John Searle, Paul Trueman, Rod Taylor

Research output: Contribution to journalArticle

115 Citations (Scopus)

Abstract

Objective To assess the impact of exercise referral schemes on physical activity and health outcomes.

Design Systematic review and meta-analysis.

Data sources Medline, Embase, PsycINFO, Cochrane Library, ISI Web of Science, SPORTDiscus, and ongoing trial registries up to October 2009. We also checked study references.

Study selection Design: randomised controlled trials or non-randomised controlled (cluster or individual) studies published in peer review journals. Population: sedentary individuals with or without medical diagnosis. Exercise referral schemes defined as: clear referrals by primary care professionals to third party service providers to increase physical activity or exercise, physical activity or exercise programmes tailored to individuals, and initial assessment and monitoring throughout programmes. Comparators: usual care, no intervention, or alternative exercise referral schemes.

Results Eight randomised controlled trials met the inclusion criteria, comparing exercise referral schemes with usual care (six trials), alternative physical activity intervention (two), and an exercise referral scheme plus a self determination theory intervention (one). Compared with usual care, follow-up data for exercise referral schemes showed an increased number of participants who achieved 90-150 minutes of physical activity of at least moderate intensity per week (pooled relative risk 1.16, 95% confidence intervals 1.03 to 1.30) and a reduced level of depression (pooled standardised mean difference -0.82, -1.28 to -0.35). Evidence of a between group difference in physical activity of moderate or vigorous intensity or in other health outcomes was inconsistent at follow-up. We did not find any difference in outcomes between exercise referral schemes and the other two comparator groups. None of the included trials separately reported outcomes in individuals with specific medical diagnoses. Substantial heterogeneity in the quality and nature of the exercise referral schemes across studies might have contributed to the inconsistency in outcome findings.

Conclusions Considerable uncertainty remains as to the effectiveness of exercise referral schemes for increasing physical activity, fitness, or health indicators, or whether they are an efficient use of resources for sedentary people with or without a medical diagnosis
Original languageEnglish
Pages (from-to)6462-6462
Number of pages1
JournalBritish Medical Journal
Volume343
DOIs
Publication statusPublished - 2011
Externally publishedYes

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Meta-Analysis
Primary Health Care
Referral and Consultation
Health
Aftercare
Personal Autonomy
Peer Review
Physical Fitness
Information Storage and Retrieval
Libraries
Uncertainty
Registries
Randomized Controlled Trials
Confidence Intervals
Exercise
Depression
Population

Cite this

Pavey, Toby ; Taylor, Adrian ; Fox, Kenneth ; Hillsdon, Melvyn ; Anokye, Nana ; Campbell, John ; Green, Colin ; Moxham, Tiffany ; Mutrie, Nanette ; Searle, John ; Trueman, Paul ; Taylor, Rod. / Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis. In: British Medical Journal. 2011 ; Vol. 343. pp. 6462-6462.
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Pavey, T, Taylor, A, Fox, K, Hillsdon, M, Anokye, N, Campbell, J, Green, C, Moxham, T, Mutrie, N, Searle, J, Trueman, P & Taylor, R 2011, 'Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis.', British Medical Journal, vol. 343, pp. 6462-6462. https://doi.org/10.1136/bmj.d6462

Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis. / Pavey, Toby; Taylor, Adrian; Fox, Kenneth; Hillsdon, Melvyn; Anokye, Nana; Campbell, John; Green, Colin; Moxham, Tiffany; Mutrie, Nanette; Searle, John; Trueman, Paul; Taylor, Rod.

In: British Medical Journal, Vol. 343, 2011, p. 6462-6462.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis.

AU - Pavey, Toby

AU - Taylor, Adrian

AU - Fox, Kenneth

AU - Hillsdon, Melvyn

AU - Anokye, Nana

AU - Campbell, John

AU - Green, Colin

AU - Moxham, Tiffany

AU - Mutrie, Nanette

AU - Searle, John

AU - Trueman, Paul

AU - Taylor, Rod

PY - 2011

Y1 - 2011

N2 - Objective To assess the impact of exercise referral schemes on physical activity and health outcomes. Design Systematic review and meta-analysis. Data sources Medline, Embase, PsycINFO, Cochrane Library, ISI Web of Science, SPORTDiscus, and ongoing trial registries up to October 2009. We also checked study references. Study selection Design: randomised controlled trials or non-randomised controlled (cluster or individual) studies published in peer review journals. Population: sedentary individuals with or without medical diagnosis. Exercise referral schemes defined as: clear referrals by primary care professionals to third party service providers to increase physical activity or exercise, physical activity or exercise programmes tailored to individuals, and initial assessment and monitoring throughout programmes. Comparators: usual care, no intervention, or alternative exercise referral schemes. Results Eight randomised controlled trials met the inclusion criteria, comparing exercise referral schemes with usual care (six trials), alternative physical activity intervention (two), and an exercise referral scheme plus a self determination theory intervention (one). Compared with usual care, follow-up data for exercise referral schemes showed an increased number of participants who achieved 90-150 minutes of physical activity of at least moderate intensity per week (pooled relative risk 1.16, 95% confidence intervals 1.03 to 1.30) and a reduced level of depression (pooled standardised mean difference -0.82, -1.28 to -0.35). Evidence of a between group difference in physical activity of moderate or vigorous intensity or in other health outcomes was inconsistent at follow-up. We did not find any difference in outcomes between exercise referral schemes and the other two comparator groups. None of the included trials separately reported outcomes in individuals with specific medical diagnoses. Substantial heterogeneity in the quality and nature of the exercise referral schemes across studies might have contributed to the inconsistency in outcome findings. Conclusions Considerable uncertainty remains as to the effectiveness of exercise referral schemes for increasing physical activity, fitness, or health indicators, or whether they are an efficient use of resources for sedentary people with or without a medical diagnosis

AB - Objective To assess the impact of exercise referral schemes on physical activity and health outcomes. Design Systematic review and meta-analysis. Data sources Medline, Embase, PsycINFO, Cochrane Library, ISI Web of Science, SPORTDiscus, and ongoing trial registries up to October 2009. We also checked study references. Study selection Design: randomised controlled trials or non-randomised controlled (cluster or individual) studies published in peer review journals. Population: sedentary individuals with or without medical diagnosis. Exercise referral schemes defined as: clear referrals by primary care professionals to third party service providers to increase physical activity or exercise, physical activity or exercise programmes tailored to individuals, and initial assessment and monitoring throughout programmes. Comparators: usual care, no intervention, or alternative exercise referral schemes. Results Eight randomised controlled trials met the inclusion criteria, comparing exercise referral schemes with usual care (six trials), alternative physical activity intervention (two), and an exercise referral scheme plus a self determination theory intervention (one). Compared with usual care, follow-up data for exercise referral schemes showed an increased number of participants who achieved 90-150 minutes of physical activity of at least moderate intensity per week (pooled relative risk 1.16, 95% confidence intervals 1.03 to 1.30) and a reduced level of depression (pooled standardised mean difference -0.82, -1.28 to -0.35). Evidence of a between group difference in physical activity of moderate or vigorous intensity or in other health outcomes was inconsistent at follow-up. We did not find any difference in outcomes between exercise referral schemes and the other two comparator groups. None of the included trials separately reported outcomes in individuals with specific medical diagnoses. Substantial heterogeneity in the quality and nature of the exercise referral schemes across studies might have contributed to the inconsistency in outcome findings. Conclusions Considerable uncertainty remains as to the effectiveness of exercise referral schemes for increasing physical activity, fitness, or health indicators, or whether they are an efficient use of resources for sedentary people with or without a medical diagnosis

KW - exercise

KW - fitness

KW - health survey

KW - human

U2 - 10.1136/bmj.d6462

DO - 10.1136/bmj.d6462

M3 - Article

VL - 343

SP - 6462

EP - 6462

JO - British Medical Journal

JF - British Medical Journal

SN - 0959-535X

ER -