COMMENTARY

A Call to Action for Clinicians to Prescribe Physical Activity

JoAnn E. Manson, MD, DrPH

Disclosures

December 14, 2015

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Hello. This is Dr JoAnn Manson, from Harvard Medical School and Brigham and Women's Hospital.

I would like to talk about a recent viewpoint piece that I and my colleagues at Stanford and the University of Central Florida have published in JAMA[1] to encourage physicians and other healthcare providers to make physical activity counseling a priority in clinical practice. There is strong evidence that healthcare professionals are considered trusted sources of health-related information and can help patients set priorities that will improve their health. Healthcare professionals can influence the adoption of healthy lifestyle practices, including physical activity.

There is strong evidence that regular physical activity—even moderate-intensity exercise, for 30 minutes per day—can substantially reduce the risk for many chronic diseases, including heart disease, stroke, diabetes, cancer, osteoporosis, cognitive decline, and even depression. If there were a medication or a pill that could simultaneously do all those things at virtually no cost and with no risk or side effects involved, everyone would be clamoring for it and all clinicians would be very anxious to prescribe it. Yet very few patients receive any discussion or counseling about physical activity, and only about one third of patients report that they have been counseled in this area. A prescription for increased activity—even 30 minutes a day of walking—could be one of the most important prescriptions that a patient receives.

We have written this viewpoint piece to be a type of call to action to encourage clinicians to incorporate physical activity counseling into practice. There is evidence that it can be done effectively with minimal lengthening of the clinic visit, and there is very strong evidence that the counseling is effective and can improve risk factor status. We presented an approach to involving the healthcare team in this counseling, which would include making physical activity a vital sign, informing the patient about the health benefits of physical activity, asking about their level of physical activity, coming to an agreement about the amount of physical activity that they are ready to commit to, writing a prescription for that amount, encouraging the patient to self-monitor activity with a pedometer or other device, and scheduling a follow-up visit to evaluate their records and assess progress. We think that this approach—including the healthcare team and making physical activity a priority in practice—will have tremendous health benefits for our patients.

We really believe that the time for action is now. Healthcare costs are increasing, and many chronic diseases could be reduced with regular physical activity. We would like to encourage clinicians to make this a priority.

Thank you for your attention. This is JoAnn Manson.

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