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

Pavey, T. G., Taylor, A. H., Fox, K. R., Hillsdon, M., Anokye, N., Campbell, J. L., Foster, C., Green, C., Moxham, T., Mutrie, N., Searle, J., Trueman, P. and Taylor, R. S. (2011) Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis. BMJ, 343 7831 Article No. d6462: . doi:10.1136/bmj.d6462

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Author Pavey, T. G.
Taylor, A. H.
Fox, K. R.
Hillsdon, M.
Anokye, N.
Campbell, J. L.
Foster, C.
Green, C.
Moxham, T.
Mutrie, N.
Searle, J.
Trueman, P.
Taylor, R. S.
Title Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis
Journal name BMJ
ISSN 0959-535X
Publication date 2011-11-04
Sub-type Article (original research)
DOI 10.1136/bmj.d6462
Open Access Status DOI
Volume 343
Issue 7831 Article No. d6462
Total pages 14
Place of publication London, United Kingdom
Publisher B M J Group
Collection year 2012
Language eng
Formatted abstract
Objective: To assess the impact of exercise referral schemes on physical activity and health outcomes.
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.
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.
Keyword Health Status
Lipid blood level
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Human Movement and Nutrition Sciences Publications
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Created: Mon, 15 Oct 2012, 17:15:52 EST by Toby Pavey on behalf of School of Human Movement and Nutrition Sciences