Research investigates exercise referral

News release from the National Coordinating Centre for Health Technology Assessment

14 May 2007

New research published by the National Institute for Health Research's Health Technology Assessment (NIHR HTA) programme suggests that GP referral for exercise classes, community-based walking, and advice on increasing physical activity may be equally effective methods to help people at risk of cardiovascular disease to improve their levels of physical activity in the short term. The clinical trial compared the effectiveness of a leisure centre-based exercise programme, an instructor-led walking programme and advice only, in patients referred for exercise by their GPs.

“Exercise helps to reduce the risk of cardiovascular disease, but seven out of 10 adults in the UK do not take enough regular physical activity,” says lead researcher Dr Anthony Isaacs. “Primary care is an important setting for encouraging people to exercise more. Exercise referral schemes, also known as exercise on prescription, have been developed to address this issue and are increasingly popular, but they have not been extensively evaluated.”

Researchers used a large local exercise referral scheme in London as the setting for the trial. The research included 943 patients aged between 40 and 74 who were not currently physically active and were identified as ‘at risk' of cardiovascular disease. Patients were referred by their GP to be assessed at a local leisure centre and were then randomly allocated to one of three groups: a leisure centre-based exercise programme, an instructor-led walking programme, or provision of advice only in the form of tailored advice and information about physical activity, including information on local exercise facilities.

Patients were assessed for changes in self-reported exercise behaviour, blood pressure and cholesterol levels, and the costs of providing and making use of the services were measured for economic evaluation.

Following up after 10 weeks and six months the researchers found that all three study groups had increased their levels of activity, and blood pressure and cholesterol levels were reduced. However, there was no significant difference between groups. The researchers concluded that, on cost-effectiveness grounds, referral for advice, supported by written materials that include details of locally available facilities, may be the most appropriate method to initiate action in the first instance. Subsidised schemes may be best concentrated on patients at higher risk, or with specific conditions for which particular programmes may be beneficial.

The Exercise Evaluation Randomised Trial (EXERT) is published in Health Technology Assessment Vol 11.10. To download the full report visit www.hta.ac.uk/project.asp?PjtId=1032

Notes:

  1. Cardiovascular risk factors included raised cholesterol; controlled moderate to mild hypertension; obesity; current smoking; diabetes; a family history of myocardial infarction at an early age.

  2. According to the British Heart Foundation, physical inactivity is the most common risk factor for heart disease. Seven out of 10 adults in the UK do not take enough regular exercise.

Notes for editors


  1. The HTA programme is a programme of the National Institute for Health Research (NIHR) and produces high quality research information about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest of the NIHR programmes and publishes the results of its research in the Health Technology Assessment journal, with more than 400 issues published to date. The journal’s 2007 Impact Factor (3.87) ranked it in the top 10 per cent of medical and health-related journals. All issues are available for download free of charge from the website, www.hta.ac.uk The HTA programme is coordinated by the National Coordinating Centre for Health Technology Assessment (NCCHTA), based at the University of Southampton.
  2. The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility.  The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training.  Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients. www.nihr.ac.uk

Contact details

Naomi Stockley, Programme Manager (Communications)
Telephone: 02380 595 646, Email: ns5@soton.ac.uk

Helen Nikandrou, Assistant Programme Manager (Communications)
Telephone: 02380 595 584, Email: h.nikandrou@soton.ac.uk

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