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Andrew Boyd
This document discusses physical activity promotion in primary care. It finds that the UK has high rates of physical inactivity compared to other countries. Regular physical activity can significantly reduce the risk of diseases like cardiovascular disease, diabetes, and cancer. However, getting patients more active is challenging for general practitioners due to time constraints, lack of knowledge, and limited local exercise options. The document recommends solutions like educational toolkits, social prescribing programs, and designating practices as health and wellness centers to address these barriers and better promote physical activity.
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- 1. Physical activity promotionin Primary Care – what works? Dr Andrew Boyd MRCGP RCGP Clinical Priority Champion: Physical Activity & Lifestyle
- 2. A little aboutme 2 A A How did I end up here?
- 3. National shift inapproach to physical activity 3 National framework domains, Everybody Active, Every Day National Strategy outcomes, Sporting Future 2015
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- 5. Your words don’tfall on deaf ears!
- 6. How does theUK compare with the following countries for inactivity? 6 A USA France Netherlands Germany Australia Finland
- 7. Proportion who areinactive 7 Public Health England (2014) Everybody Active, Every Day; Based on Hallal PC et al. (2012) Global physical activity levels: surveillance progress, pitfalls, and prospects. The Lancet. International comparison of physical inactivity (at ages 15 and over) Note: Comparator = Not meeting any of the following per week: (a) 5 x 30 mins moderate-intensity activity; (b) 3 x 20 mins vigorous-intensity activity; (c) equivalent combination achieving 600 metabolic equivalent-min. UK 63.3% USA 40.5% Australia 37.9% Finland 37.8% France 32.5% Germany 28.0% Netherlands 18.2% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% % Inactive
- 8. Physical activity: Whogains the most? 8 Moore et al. (2012) PLOS Medicine A 150 Minutes Biggest gain in years
- 9. Physical activity reducesthe mortality and morbidity risk of disease 9 Start Active, Stay Active (2011) based on US Department of Health and Human Services Physical Activity Guidelines Advisory Committee Report (2008), Washington DC A Disease Risk reduction Strength of evidence Osteoarthritis disability 22-80% Moderate Alzheimer’s disease 20-30% Moderate Hip fracture 36-68% Moderate Depression 20-30% Moderate Early death 20-35% Strong CHD and stroke 20-35% Strong Type 2 diabetes 35-40% Strong Colon cancer 30-50% Strong Breast cancer 20% Strong Hypertension 33% Strong Functional limitation, elderly 30% Strong Prevention of falls 30% Strong
- 10. Lies, damn lies,and statistics… • 25% of the UK adult population ‘inactive’ • >40% of the population ‘not active enough for good health’ • Inactivity 4th biggest risk factor for NCD • 300million GP & patient consultations per annum • 75% GP discuss lifestyle ‘often/always’ • So… why isn’t the message getting through?
- 11. Barriers – GPperceptions • Time - 10 minutes to talk about everything! • Lack of knowledge • Fear of offending patients • Perceived lack of services locally • Reliability of services - who can I trust?
- 12. What we learnt… •Behaviour change takes time – think smoking • PHE teaching will reach some but not all • There are HCPs doing great work already • There is an appetite for this – patients and HCPs • Genuine concerns re: medicolegal limbo • One size definitely doesn’t fit all
- 13. Solutions - knowledge •RCGP toolkit – ‘motivate to move’ – disease specific • Podcasts • Videos • Events – regional workshops, conferences, media presence • Moving Medicine
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- 15. Solutions – advocacyand empowerment • The Active Practice –the power of the med student • The case for PA –commissioners • The case for surgeries • The case for the PA industry • The case for the voluntary/third sector • Universal cross sector medicolegal guidance • Doctors and HCPs as leaders and activists
- 16. Taking a stand! Stefanet al. (2013) Lancet Diab Endocrinol16
- 17. Becoming a localleader • Look for allies • Join or start a network • ‘Lifestyle’ medicine: RCGP, PHE, BSLM, social media • Grants and bids – charities, CCG, research • Events - Elevate, UKactive, ISPAH, BSLM conference, FSEM, BASEM
- 18. Social Prescribing: asolution? • GPs can’t do it all – but can sew a seed • For more complex patients • In-depth knowledge of local services • Health sec promise for universal access • Emerging evidence of efficacy • Are they including PA in their offer?
- 19. Walk Map Learn– a local initiative
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- 21. The future • Surgeriesas health/wellness centres • PA as the norm not just for weirdos in lycra! • Embedding in other health priorities – PCC; clusters;resilience • PA recognised as a good value safe ‘medicine’ for all • Positive partnerships across sectors nationwide
- 22. Resources • Motivate toMove gpcpd.walesdeanery.org • Moving Medicine www.fsem.ac.uk • RCGP Physical Activity Toolkit www.rcgp.org.uk • Arthritis UK PILs www.arthritisresearchuk.org • Disease charities – Richmond Group • One You app www.nhs.uk/oneyou • NHS Live Well www.nhs.uk/live-well/exercise/ • Chair based www.bhf.org.uk/heart-matters-magazine/activity/chair- based-exercises And many many others…
- 23. Get in touch •RCGP Physical Activity & Lifestyle Clinical Priority [email protected] • PHE Clinical Champions [email protected] • British Society of Lifestyle Medicine bslm.org.uk Thank you!