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NICE Underpinning Review
"This project updates a previous review of physical activity advice in primary care and consists of one report with the following two components, which aim to investigate the effectiveness of, and the barriers and facilitators for, brief advice interventions in primary care to promote physical activity in adults."
"Twenty one trials including 12 RCTs, four cluster RCTs and five non-randomised controlled trials (nRCT) were included in the review. The most commonly reported outcomes were self-reported levels of physical activity.
Sixteen studies compared brief advice with usual care and fifteen of these reported results for self-reported physical activity. Of the fifteen studies that reported physical activity outcomes; seven found that the effects were statistically significant showing a positive effect of interventions in promoting physical activity. One study found that there were greater benefits in increased physical activity in the control group compared to the brief advice group and one found no difference between groups.
Eight studies reported continuous measures of physical activity which were combined using standardised mean difference. Meta-analysis of these eight studies showed a statistically significant effect favouring brief advice over usual care (standardized mean difference 0.17 (0.06 to 0.28); I2 69%."
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Some barriers and facilitators to delivering brief advice (provide views) include: perceived patient characteristics; perceived likely uptake of advice; perceived effectiveness of physical activity advice and or/prescribing; print materials, incentives, and others support resources; time resources and conflicting priorities; confidence and knowledge (and the need for further training/support); practitioner activity level; within their remit/role; advice is curative not preventative (i.e. linked to a presenting condition).
Some barriers and facilitators to the uptake of brief advice (patient views) include: current level of activity; recall/understanding of advice; need to receive more preventative advice (not linked to presenting condition); unaware of physical activity recommendations; need to feel listened to; physician’s role/characteristics."