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Factors associated with patients self-reported adherence to prescribed physical activity in routine primary health care
Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.
Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
Department of Neurobiology, Health Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-8031-7651
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2010 (English)In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 11, no 38Article in journal (Refereed) Published
Abstract [en]

Background: Written prescriptions of physical activity, so‐called physical activity referral (PAR) schemes, have increased in popularity in recent years. Such schemes have mostly been evaluated in terms of efficacy. This study reports on a Swedish PAR scheme implemented in routine primary health care (PHC) measuring patients’ self‐reported adherence to physical activity prescriptions. The aim of this study was to evaluate adherence to physical activity prescriptions issued in everyday PHC at 3 and 12 months and to analyse the different characteristics associated with adherence to these prescriptions.

Methods: Prospective prescription data were obtained for 37 of the 42 PHC centres in Östergötland County, Sweden, during 2004. The study population consisted of 3300 patients issued PARs by ordinary PHC staff members. Odds ratios were calculated to identify the factors associated with adherence.

Results: The average adherence rate was 56% at 3 months and 50% at 12 months. In the descriptive analyses, higher adherence was associated with increased age, higher activity level at baseline, home‐based activities, prescriptions issued by professional groups other than physicians, and among patients issued PARs due to diabetes, high blood pressure and “other PAR reasons”. In the multiple logistic regression models, higher adherence was associated with higher activity level at baseline, and to prescriptions including home‐based activities, both at 3 and 12 months.

Conclusions: Prescriptions from ordinary staff in routine PHC yielded adherence in 50% of the patients in this routine care PAR scheme follow‐up. Patients’ activity level at baseline (being at least somewhat physically inactive) and being issued homebased activities were associated with higher adherence at both 3 and 12 months.

Place, publisher, year, edition, pages
London, UK: BioMed Central, 2010. Vol. 11, no 38
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-16824DOI: 10.1186/1471-2296-11-38ISI: 000279851800001OAI: oai:DiVA.org:liu-16824DiVA: diva2:174275
Note

Original Publication:Matti E. Leijon, Preben Bendtsen, Agneta Stahle, Kerstin Ekberg, Karin Festin and Per Nilsen, Factors associated with patients self-reported adherence to prescribed physical activity in routine primary health care, 2010, BMC Family Practice, (11), 38.http://dx.doi.org/10.1186/1471-2296-11-38Licensee: BioMed Centralhttp://www.biomedcentral.com/

Available from: 2009-02-20 Created: 2009-02-20 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Activating People: Physical activity in the general population and referral schemes among primary health care patients in a Swedish county
Open this publication in new window or tab >>Activating People: Physical activity in the general population and referral schemes among primary health care patients in a Swedish county
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In this thesis the need for physical activity interventions is investigated in a general adult population, the characteristics of physical activity referral (PAR) scheme recipients and referral practitioners, and the effectiveness of PAR in a routine primary health-care (PHC) setting in the county of Östergötland, Sweden. The thesis consists of four papers: three papers are based on a quantitative, uncontrolled prospective PAR study and one paper is based on a population survey in the county of Östergötland, Sweden.

In 2006, only one in four of the adult population, aged 18–84 years, in Östergötland was considered sufficiently active to meet the Swedish national public health recommendations, stated as “30 minutes of moderate physical activity a day”. More than one-third (37%) reported that they hade no intentions to change their physical activity levels, while 36% had thought about change, and 27% were determined to change. Although the individuals felt a large responsibility for their own physical activity, they also believed that this responsibility is partly shared by health-care providers. Among those who wanted to increase their physical activity level, almost one in seven of the total population and one in four among those reporting poor general health, with a BMI over 30 and those who were inactive reported that they wanted support to bring about this change. More than half of them wanted this support from their health-care provider.

During 2004 and 2005, a total of 6300 patients received PARs as part of the Östergötland PAR scheme. Two-thirds of the patients were female and half of the patients were 45–64 years old. The PAR scheme reached a relatively high proportion of physically inactive people. PARrelated statistics, including the numbers of referrals made at individual PHC centres and by different professional categories, showed large differences in prescribing activities, both by patient categories, and by prescribing professionals, indicating great potential for further improvements of this scheme in the future.

Half of the patients (51%) who received PARs were recommended home-based activities, such as walking. Patient follow-up showed that an increase in self-reported physical activity level was achieved by 52% of the patients at the 12-month follow-up. The proportion of inactive patients decreased from 33% at baseline to 20% at 12 months. The proportion of patients who were physically active on a regular basis increased from 22% at baseline to 32% at 12 months. Neither patient age, diagnosis/PAR reason nor the profession of the prescriber were associated with differences in effectiveness. Low activity levels at baseline and homebased activities were significantly associated with increased physical activity at 12 months. Half of the patients (50%) achieved adherence to PARs at the 12-month follow-up, with adherence assessed by simply asking the patients about their adherence to prescribed activity. Patients’ activity levels at baseline (being at least somewhat physically active) and being issued home-based activities were significantly associated with higher adherence at 12 months.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 100 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1096
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16825 (URN)978-91-7393-710-8 (ISBN)
Public defence
2009-03-11, Aulan i Hälsans hus, ingång 16, Campus US, Linköpings Universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2009-02-20 Created: 2009-02-20 Last updated: 2017-06-30Bibliographically approved

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Leijon, Matti E.Bendtsen, PrebenEkberg, KerstinFestin, KarinNilsen, Per

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Social Medicine and Public Health ScienceFaculty of Health SciencesDepartment of Medical Specialist in MotalaWork and RehabilitationHELIX Vinn Excellence Centre
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