Effectiveness of Physical Activity Advice and Prescription by Physicians in Routine Primary Care A Cluster Randomized Trial
Effectiveness of Physical Activity Advice and Prescription by Physicians in Routine Primary Care A Cluster Randomized Trial
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DOI：
10.1001/archinternmed.2009.23
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发表时间：
2009-04-13
影响因子：
--
通讯作者：
Serra, Javier
中科院分区：
文献类型：
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作者：
Grandes, Gonzalo;Sanchez, Alvaro;Serra, Javier
背景：身体活动的促进是一个优先事项，但医生的干预的贡献是不清楚的。PEPAF的有效性（“实验计划促进体力活动”），这是完全由医生在常规的初级保健从2003年10月至2004年12月，进行了assessed.Methods：五十六西班牙家庭医生随机干预（n=29）orstandardcare（n=27）手臂的试验。医生从系统样本中招募了4317名不活动的患者（2248名为干预组，2069名为对照组），评估了他们在常规实践中的身体活动。干预医生为所有患者提供建议，并为参加额外预约的亚组（30%）提供体力活动处方。主要结果测量是由盲法护士使用7天体力活动回忆测量的体力活动变化。次要结果包括心肺功能和健康相关的生活quality of life.Results：在6个月时，干预患者增加的体力活动多于对照组（调整后差异，18 min/wk [95%置信区间，6-31 min/wk];代谢当量任务x每周小时数，1.3 [95%CI，0.4-2.2]）。达到最低体力活动建议的人群比例在干预组中高出3.9%（1.2%-6.9%;需要治疗的人数，26）。次要结局无差异。干预的效果在50岁以上的受试者中得到了积极的改善（P
Background: Physical activity promotion is a priority, but contribution of physicians' interventions is unclear. The effectiveness of the PEPAF("Experimental Program for Physical Activity Promotion"), which was implemented exclusively by physicians in routine primary care from October 2003 to December 2004, was assessed.Methods: Fifty-six Spanish family physicians were randomized to either the intervention (n=29) orstandardcare(n=27) arm of the trial. The physicians recruited 4317 physically inactive patients (2248 for intervention and 2069 for control protocols) from a systematic sample after assessing their physical activity in routine practice. Intervention physicians provided advice to all patients and a physical activity prescription to the subgroup attending an additional appointment (30%). The main outcome measure was the change in physical activity measured by blinded nurses using the 7-Day Physical Activity Recall. Secondary outcomes included cardiorespiratory fitness and health-related quality of life.Results: At 6 months, intervention patients increased physical activity more than controls (adjusted difference, 18 min/wk [95% confidence interval, 6-31 min/wk]; metabolic equivalent tasks x hours per week, 1.3 [95% CI, 0.4-2.2]). The proportion of the population achieving minimal physical activity recommendations was 3.9% higher in the intervention group (1.2%-6.9%; number needed to treat, 26). No differences were found in secondary outcomes. The effect of intervention was positively modified in subjects older than 50 years ( P