Prescribing exercise in primary care

Chronic diseases—the leading causes of morbidity and mortality—are strongly linked to unhealthy lifestyles. The World Health Organization recently published a report on global health risks.1 Leading causes of global mortality are high blood pressure (13% of total deaths), tobacco use (9%), high blood glucose (6%), physical inactivity (6%), and obesity (5%). Physical inactivity is fourth on this list, but it influences most of the other causes. The importance of physical activity in preventing and treating many diseases and conditions is indisputable, as documented by the authoritative, accessible, and practical guide of the Swedish Professional Associations for Physical Activity.2 Reports from the United States,3 Canada, and the United Kingdom concur.4

Physical activity is a complex behaviour, and modern physical and social environments discourage it. Countering these influences will require a coordinated approach involving multiple societal, institutional, and departmental collaborations.5 Clinicians need to contribute. Healthcare is one of eight sectors listed in the US national physical activity plan that aims to influence activity (www.physicalactivityplan.org/theplan.php).6 Advice on physical activity in primary care is a pillar of WHO’s global physical activity plan (2010).7 Physical activity counselling in clinical settings provides “exceptional value for money.”4

Based on the recommendation of the Swedish physical activity book,2 key principles of the US physical activity plan, and the UK’s Department of Health’s Let’s Get Moving,8 the following steps can …