PRESCRIPTION FITNESS

If we had a pill that conferred all the proven health benefits of exercise, physicians would prescribe it to every patient and our healthcare system would find a way to make sure every patient had access to this wonder drug.

So let’s look at this new wonder drug ‘exercise’: l Exercise is a natural side effect free medicine l In a practice of 10,000 about 6,600 will require exercise . However 7,100 believe they do not have deficiency

l Give exercise to 60 inactive men over 60 yrs and every year one less will die compared to the control group

l Exercise can delay onset of diabetes for an average of 3.6 yrs even up to 14 yrs after intervention

l Most GPs understand the importance of prescribing exercise to control pain in osteoarthritis. However 29% from a recent study thought that rest was the best treatment.

l Although exercise is recommended in NICE guidelines GPs are not told whether they should – refer patients – advise patients – or prescribe to patients

l Exercise has a similar effect to most antidepressant and cognitive behavioural therapy and is considerably cheaper.

l A long term supplement of exercise can delay the onset of dementia and can increase independence in the elderly

l Exercise improves maternal and baby health and helps with post-natal care too

l Those with exercise deficiency account for: – 38% more days in hospital – 5.5% more GP visits – 13% more specialist services – 12% more nurse visits – A billion spent on drugs bills

l A total of 27 million people suffer from exercise deficiency — total cost to NHS over £1 billion

Massive in-roads are already being made to encourage more medics and healthcare professionals to “prescribe” medicine, for example the work the FIA and REPs are doing with six of the Royal Medical Colleges as part of the Joint Consultative Forum, and the guidelines set out in the new Government White Pater, but there’s still a long way to go.

In an article called The Fitness, Obesity and Health Equation – is Physical Activity the Common Denominator? published in The Journal of the American Medical Association, the authors are quoted as saying:

“The medical community needs to lead in communicating the importance of physical activity for health and weight management. Just as weight is addressed in some manner at nearly every physician visit, so should attention be given to recommending the accumulation of 30 minutes a day of moderate intensity physical activity at least five days of the week.”

I’m sure I’m not alone in feeling great frustration that as exercise professionals we can offer motivational support, professional qualifications, the right equipment, variety and modern and safe exercise training methods to help tackle this growing crisis.

In an ideal world I’d like to see a large-scale exercise initiative www.exerciseregister.org

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that works with EACH patient - Every patient; Every visit; Every treatment plan!

The message would be the same from every health professional – physical activity should be recorded as a vital sign with each and every patient being asked about their exercise habits at each visit so this can be recorded with their BP, HR, temp, BMI and smoking history.

It might be a dream for now but who knows what the future might hold….

References 1. Chronic Diseases and Development, The Lancet November 2010:DOH, NCHOD, Department of Works and Pensions, BBC website

2. CHD, Diabetes, Falls, Mental Health, Osteoporosis, COPD. THE AUTHOR T

Ann qualified as a pharmacist more than 20 years ago and has nearly 30 years experience of working in the NHS developing services for patients with chronic diseases. She is passionate

about exercise and decided to train as a PT and chronic disease exercise specialist after being inspired by her ex- army PT. She runs her own educational consultancy business called Exercise-Works!, which aims to provide evidence- based exercise advice and support to health professionals, patients and the public. For more information visit www.exercise-works.org