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Research questions the cost-effectiveness of exercise referral schemes

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A new study involving researchers from Brunel’s Health Economics Research Group (HERG) has called into question the effectiveness of exercise referral schemes in increasing physical activity and improving health outcomes for those living a sedentary lifestyle.

The research, published in the British Medical Journal this week, suggests that referring patients to an exercise specialist at a local gym or sports centre may be no more effective than simply giving advice on physical fitness. Findings included:
  • ‘weak evidence’ that referrals increased patients’ physical activity and reduced depression after 12 months, compared to those who had only received advice;
  • no demonstrable difference between referring patients and promoting other physical activity such as a walking programme;
  • no consistent evidence that a referral improved physical fitness, psychological well-being, overall health-related quality of life, blood pressure, obesity, glycaemic control or respiratory function.
Dr Toby Pavey, Associate Research Fellow at the Peninsula College of Medicine and Dentistry, which coordinated  the study, said: “Our study does not question the importance of physical activity for good health: what it does do is question the effectiveness of the exercise referral programme as it is delivered at present. It is clear that with increasing pressure on NHS budgets and changes to the way in which services are commissioned as part of current NHS reforms, more work needs to be done to establish how existing referral programmes may be made more effective and who they should be targeted towards.”

HERG Research Fellow Dr Nana Anokye added: “In the absence of more robust effectiveness data, the economic case for exercise referral schemes remains encouraging but ultimately equivocal.”

The study was commissioned by the NIHR Health Technology Assessment programme and carried out by research teams from the Peninsula College of Medicine and Dentistry and the University of Exeter, as well as HERG.