Exercise on prescription: Guidelines for health professionals

Exercise has the capability to improve many aspects of health, yet national surveys have indicated that the general population is not exercising sufficiently for such benefits to accrue. With a great proportion of the population attending general practices each year, general practitioners have a unique opportunity to increase the prevalence of exercise. With such a realization, 'exercise on prescription' schemes, in which general practitioners prescribe exercise as an alternative to medication, have become increasingly popular within the United Kingdom. However, few guidelines as to good practice exist. This paper aims to bridge this gap prior to the availability of detailed evaluations, by drawing upon the experiences of a scheme established in 1993 by the LIFE Project, a community-based heart disease prevention programme. The scheme currently has 22 general practices referring patients to a coordinator who decides upon the most appropriate form of exercise prescribed after an introductory consultation and a health check. To date, over 600 patients have been referred. The paper focuses upon various aspects associated with exercise on prescription including patient selection, targeting of general practices and leisure venues, ethical considerations, adherence issues, and the most appropriate specific exercise options.