Investigating the role of general practitioners in prescribing physical activity in Belgium

Sherihane Bensemmane, Fanny Brunin, Greet Cardon, Stefan Heytens, Robrecht De Schreye

Keywords: general practitioners, physical activity, lifestyle, prescription

Background:

In Belgium, almost 30% of the population over the age of 15 is exposed to a health risk due to physical inactivity. Evidence shows that physical activity on prescription (PAP) has a positive impact on PA levels and metabolic health.

Research questions:

What is the current involvement of GPs in PAP?

Method:

First, a mapping exercise was carried out to identify initiatives and policies related to PAP. Second, a cross-sectional online survey was conducted among GPs. Third, a population-based study of data collected by the Belgian Sentinel GPs (SGP) network in 2023. Descriptive statistics were performed.

Results:

In Belgium, about 40 initiatives and 8 policies were identified. PAP was provided through either coaching (motivational) sessions and/or collective adapted physical activity sessions. Different providers were identified : primary healthcare centres, non-governmental organisations, pilot projects launched by governmental agencies, sport centres, and hospitals. Amongst PAP initiatives, GPs were always reported as prescribers.
134 GPs completed the survey. Among respondents, 75% identified chronic disease and exercise initiation as incentives for PAP whilst 44% reported discussing the benefits of PA with patients living with a chronic disease. 86.8% (would) prescribe if patients' health status would be remedied by increasing PA, while 35.8% (would) use PAP if patients are inactive, regardless of their health status.
Between January and December 2023, 22 PAP were reported by SGPs. 63.7% of cases concerned female patients and median age was 53.5 [Q1 38.3; Q3 75.0]. Almost all individuals (95.5%) had a chronic condition, with the most commonly reported condition being overweight/obesity (81.8%), low back pain (36.4%), depressive disorders (33.5%) and hypertension (27.3%).

Conclusions:

In Belgium, PAP exists in different forms. GPs used (were willing to use) PAP in their practice and were identified as the main prescribers. PAP was often used for primary and secondary prevention, often focusing on patients with a chronic disease.

Points for discussion:

Can PAP be routinely implemented as a non-medical therapeutic strategy to counter the health risks associated with inactivity and sedentary behavior?

Facilitators and barriers to scale-up the implementation and use of PAP

#124