Physical activity on prescription as a method for treatment of patients with metabolic syndrome in primary health care. A 6-month follow-up regarding physical activity level, metabolic risk factors and health-related quality of life.

Conference: 
Talk Code: 
1D.5
Presenter: 
Stefan Lundqvist
Co-authors: 
Stefan Lundqvist1, Maria EH Larsson1, Mats Börjesson2, Lars Hagberg3, Åsa Cider1.
Author institutions: 
1University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Department of Health and Rehabilitation/Physiotherapy, Sweden, 2Institution of Neuroscience and Physiology, Department of Food and Nutrition and Sport Science, Gothenburg University and Sahlgrenska University Hospital/Östra, Gothenburg, Sweden 3 Region Örebro County, University Health Care Research Center,

Problem

There is strong evidence that inadequate physical activity (PA), according to public health recommendation, leads to health problems with increased risk of lifestyle-related diseases and premature mortality. In the primary care of Gothenburg, a Swedish model of physical activity on prescription (PAP) has been used as a method to increase the level of physical activity in patients with inadequate PA-level visiting one of 15 health care centres.

The aim of the study was to follow the degree of change in PA-level and the proportion of patients moving from inadequate to sufficiently physically active at 6-months follow-up with PAP-treatment. Further aim was to evaluate and compare PA-level, at 6-months follow-up, with metabolic risk factors and health-related quality of life and to measure the support from caregiver at the health care centre.

 

Approach

Included in this observational follow-up study were 444 patients, age 30-80 years, 56 % women, physically inactive with at least one component of the metabolic syndrome. The PAP-treatment model included: individualized dialogue concerning physical activity, prescribed PAP and a structured follow-up.

Findings

A total of 368 patients (83 %) completed the 6-month follow-up. In the whole group, 270 patients (75%) had increased their physical activity level and 153 patients (42%) had moved from being inadequately to being sufficiently physically active. Regarding metabolic risk factors, significant improvements (p≤ 0.05) were shown in: body mass index (BMI), waist circumference, systolic blood pressure, fasting plasma glucose, cholesterol and low density lipoprotein (LDL). Significant improvements regarding health-related quality of life, assessed by Short Form 36 (SF-36), were shown in: general health, vitality, social function, mental health, role limitation-physical/emotional, mental component summary and physical component summary. A multivariate regression analysis showed significant associations between changes in PA-level and health outcome. During the first 6 month period patients received caregiver-PAP-support 1-2 times.

Consequences

The use of PAP-treatment in daily clinical work at primary health care centres is associated with improvements in PA-level, metabolic risk factors and health-related quality of life at 6-months follow-up. A majority of the patients got PAP-support 1-2 times during the 6 month period which may be considered as a small effort and a relatively low-budget intervention.

Submitted by: 
Stefan Lundqvist