New guidance on brief advice for adults undertaking exercise in primary care

Asleep at the desk

“Nudging” people to change their behaviour is one of the concepts du jour.  In the cash- and time-strapped environment of health care delivery, the idea that small scale interventions can have a big collective impact particularly appeals.

NICE has recently released guidance for primary care professionals on how to deliver brief advice on undertaking exercise.  The recommendations deal with five main areas:

  1. Identifying adults who are inactive
  2. Delivering and following up on brief advice
  3. Incorporating brief advice in commissioning
  4. Systems to support brief advice
  5. Providing information and training.

What do they mean by “brief advice”?

The term ‘brief advice’ is used in this guidance to mean verbal advice, discussion, negotiation or encouragement, with or without written or other support or follow-up. It can vary from basic advice to a more extended, individually focused discussion.

All primary care care professionals with a responsibility for encouraging physical activity can deliver this type of advice.

What are the benefits?

Increasing physical activity prevents and improves cardiovascular disease, diabetes, stroke, mental health, musculoskeletal disorders and has a positive impact on quality of life.

Megaphone

Further evidence is needed to identify the best way of delivering the advice

Quality of evidence

The evidence was reviewed by the Public Health Intervantions Advisory Committee.  They concluded that there is good evidence that brief advice has a modest but consistent positive effect on physical activity levels.  They also note that evidence is unclear on the optimal form or mode of dlivery.  However, cost-effectiveness analysis suggests that giving brief advice is cost-effective compared with usual care.

Reference

National Institute for Health and Care Excellence (NICE).  Physical activity: brief advice for adults in primary care (PH44).  Public Health Guidance, May 2013.