ABC of prescribing exercise as medicine: a narrative review of the experiences of general practitioners and patients.
ABC of prescribing exercise as medicine: a narrative review of the experiences of general practitioners and patients.
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DOI：
10.1136/bmjsem-2021-001050
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发表时间：
2021
影响因子：
4.8
通讯作者：
Niranjan V
中科院分区：
文献类型：
--
作者：
O'Regan A;Pollock M;D'Sa S;Niranjan V
运动处方可以帮助患者克服运动不足，但在全科医生中的使用有限。这篇叙述性综述的目的是调查全科医生和服用运动处方的患者的同期经历。PubMed、Scope us、Science Direct和Cochrane的评论都使用了“运动处方”、“运动处方”、“家庭实践”、“全科实践”、“成人”和“体力活动处方”等术语进行审查。经过标题、摘要和全文的筛选，23篇研究入选。定性、定量和混合方法研究揭示了全科医生和患者的关键经验。确定的障碍包括：医生特征、患者的身体和心理社会因素、制度和文化失败，以及关于运动处方的模棱两可。我们使用ABC方法综合了克服这些问题的关键策略：A：体力活动评估：包括询问体力活动、实施运动处方的障碍和风险；B：短暂干预：建议，详细说明运动频率、强度、时间和类型的书面处方；以及C：持续支持：提供持续监测、问责和处方进展。确定了多种支持：方便用户的资源、医生讲习班、特定疾病和多发病指南、电子设备、保健系统支持以及与其他保健和锻炼专业人员的合作。这项审查确定了促进运动处方和坚持运动处方的杠杆。研究结果已以ABC格式公布，作为全科医生开出运动处方的指南和支持。
Exercise prescribing can help patients to overcome physical inactivity, but its use in general practice is limited. The purpose of this narrative review was to investigate contemporaneous experiences of general practitioners and patients with exercise prescribing. PubMed, Scopus, Science Direct and Cochrane reviews were reviewed using the terms ‘exercise prescription’, ‘exercise prescribing’, ‘family practice’, ‘general practice’, ‘adults’ and ‘physical activity prescribing’. After screening by title, abstract and full paper, 23 studies were selected for inclusion. Qualitative, quantitative and mixed-methods studies revealed key experiences of general practitioners and patients. Barriers identified included: physician characteristics, patients’ physical and psychosocial factors, systems and cultural failures, as well as ambiguity around exercise prescribing. We present a synthesis of the key strategies to overcome these using an ABC approach: A: assessment of physical activity: involves asking about physical activity, barriers and risks to undertaking an exercise prescription; B: brief intervention: advice, written prescription detailing frequency, intensity, timing and type of exercise; and C: continued support: providing ongoing monitoring, accountability and progression of the prescription. Multiple supports were identified: user-friendly resources, workshops for doctors, guidelines for specific illnesses and multimorbidity, electronic devices, health system support and collaboration with other healthcare and exercise professionals. This review has identified levers for facilitating exercise prescribing and adherence to it. The findings have been presented in an ABC format as a guide and support for general practitioners to prescribe exercise.