The clinical effectiveness and cost-effectiveness of exercise referral schemes: a systematic review and economic evaluation

Abstract

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The Busy General Practitioner’s Reference Guide to Increasing Physical Activity Levels in the British population and Associated Benefits/Risks: A Review of the Literature

“…Anokye and Trueman [27] demonstrated that the cost per QALY reduces further when schemes are targeted at sedentary patients suffering from obesity, hypertension or depression due to cost savings associated with the treatment of the chronic disease in addition to those gained from a reducing inactivity. These findings are broadly similar to those in other countries, and the most recent review by Pavey et al [28] found adherence rates of 49% for observational studies and 43% for randomised controlled trials. Although studies lack sufficient power to calculate statistics, baseline activity, obesity and age seem to be the only factors influencing whether patients complete the ERS.…”

“…NICE guidance (2006) stated that ERS's should "not be commissioned in primary care outside of well designed research studies" and this is not due to be updated until March 2013 (NICE, personal communication [30]; July 2012). NICE guidance on ERS's has not been disputed by recent meta-analyses which demonstrated that the proportion of patients involved in ERS's who met Government guidelines for PA only increased by 11% [28] and 16% [14].…”

“…Exercise prescriptions most recently been updated by the American College of sports medicine to include prescriptions for various health conditions such as hypertension, cardiovascular disease, obesity, type 2 diabetes, osteoarthritis, osteoporosis and depression [30] and are shown in Appendix 2. Typically exercise prescriptions do not involve supervision and a 10 week study found that supervised sessions have little benefit over non-supervised prescriptions [28].…”

Exercise on referral: evidence and complexity at the nexus of public health and sport policy

“…Exercise on referral schemes (ERS) are one of the most widespread physical activity interventions in the United Kingdom, with a sustained rise in number initiated since the early 1990s (Pavey et al 2011). Usually commissioned via public health, they involve referral of patients with long-term conditions from primary care to a third party (typically a leisure provider), where a programme is provided that aims to encourage participants to increase their physical activity levels.…”

A systematic review and economic evaluation of exercise referral schemes in primary care: a short report

“…5 By 2005, 89% of primary care organisations in England ran an ERS, making it one of the most common forms of physical activity intervention in primary care. 6 Five previous systematic reviews [7][8][9][10][11] have been undertaken in this area exploring the effectiveness of ERSs. There was a lack of consistency in the included studies in each of these reviews, revealing a different understanding and interpretation of ERSs between authors.…”