PCN doctors write exercise prescriptions

Farida Ali had no idea she could fill the prescription she got from her family doctor at the gym.

The 55-year-old was living with diabetes and suffering a severe bout of depression when her doctor prescribed exercise as part of the Prescription To Get Active program.

"The way I was, I was really down. I needed to get out and do something, otherwise it would have gotten worse," she says. "I was so dependent on medication."

Through the program, patients receive an exercise prescription they can then redeem at one of several municipal exercise facilities across the capital region.

Prescription To Get Active was launched by the Edmonton and area Primary Care Networks in February. Physicians at the St. Albert and Sturgeon Primary Care Network are now on board.

Servus Credit Union Place is offering a free day pass for those with an exercise prescription.

The prescriptions are addressing sedentary behaviour before it results in chronic health problems, says Jack Ballash, Servus Place manager.

"We're hoping to be proactive and get people active, so long term they're not going to have as many complications with diabetes or obesity that we are seeing becoming epidemic in today's society."

Ali redeemed her prescription at the Castle Downs YMCA, where they offer a free month pass.

She would work out every other day on the treadmill, stationary bike or the pool.

Exercise helped to get her diabetes under control as well as her mental health, she says.

"I'd rather go to the gym than talk to a group of people about my problems," says Ali.

Instead of pushing medication, doctors should encourage their patients to get active, says Lisa Noble, member services supervisor at the Castle Downs YMCA.

"I would like to see more doctors prescribing it. We're not just selling gym memberships, we're selling health."

RxActive

In an editorial published in the British Journal of Sports Medicine in 2011, California-based family physician Dr. Robert Sallis acknowledged that the medical community has resisted attempts to utilize exercise as a medication.

He encourages health care providers to obtain an "exercise vital sign" on every patient by asking them how many days per week and the duration they engage in moderate or greater physical activity.

"I would suggest it makes more sense to stop measuring blood pressure at every visit than to ignore our patients' exercise habits, because we know that being sedentary is a bigger risk factor for mortality than mild to moderate levels of hypertension," he writes.

Sallis also suggests health care professionals forge a better link with the fitness industry in order to help patients overcome barriers to carrying out an exercise prescription.

Only about half of the patients who have come in with an exercise prescription have subsequently purchased a gym membership, says Noble.

Reasons for not continuing include weather, location and price – there are however subsidized membership options at the YMCA, she notes.

Servus Place has only received two exercise prescriptions so far, says Ballash.

He hopes the interest, and the numbers of prescriptions doctors give out, will ramp up now that the local PCN is participating.

On the prescription, doctors can specify the intensity, duration and frequency of recommended physical activity.

The Prescription to Get Active program is meant for individuals who need to be more active and who can exercise without supervision or medical restrictions.

The goal for adults is to work up to a minimum of 150 minutes of physical activity per week. Participants can track their activity progress online.

Prescription to Get Active launched in 2011 in Leduc and has since expanded to include at least nine primary care networks and 20 recreation centres. The initiative is based on the Green Prescription program from New Zealand.

"It doesn't matter what gym they go to, as long as they're moving … getting out and getting active," adds Noble.