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.
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.
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.
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.
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.