How can physical activity promotion be optimised in general practice: a narrative review of the literature

Background Physical inactivity is a significant contributor to preventable chronic health conditions worldwide. General practice has been identified as a setting to improve physical activity levels through exercise promotion during consultations. However, physical activity promotion in general practice is unstructured and suboptimal. Aims The aim of this study is to review the literature pertaining to factors that influence physical activity promotion in general practice and to answer the research question: what are the experiences of patients and GPs with physical activity promotion in consultations? Methods Online databases were searched for relevant papers using predetermined inclusion and exclusion criteria. Papers retrieved were original research only, involving patients, general practitioners or practice nurses. A PRISMA approach to study selection was followed. Results Of 464 papers retrieved, 20 were included in the review. Physical activity promotion is acceptable to patients but some do not appreciate its health benefits. A personalised approach is important to patients, including tailored advice and setting meaningful goals. Studies involving general practitioners and practice nurses report that they are aware of the importance of physical activity and their role in its promotion, but time is the primary barrier. Strategies identified include demedicalisation of physical activity, resources such as patient handouts as well as signposting to community initiatives, social prescribers and collaboration with exercise professionals. Conclusion General practice has the potential to effectively promote physical activity but system- and practitioner-level changes are necessary to achieve meaningful change.