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Lifestyle Prescriptions: A Review of the Clinical Evidence

Rapid Response Report: Summary with Critical Appraisal

According to the World Health Organization (WHO), physical inactivity constitutes the fourth leading risk factor for death globally. In 2008, nearly 1/3 of the world’s adults aged 15 years or older were considered insufficiently active (men: 28%, women: 34%). The reasons for this inactivity are manifold including a reduction in leisure time physical activity (PA), increases in occupational and domestic sedentary behavior, and increases in passive modes of transportation, along with the trend toward increasing urbanization and its associated environmental factors, some of which may serve to discourage PA. In spite of these challenges, however, the argument for promoting PA as a population health strategy remains compelling since participation in regular PA has been reported to produce broad health benefits, including prevention or delay of chronic illnesses, such as diabetes and cardiovascular disease (CVD), which can carry a high health and cost burden to the individual and to society. Because of accessibility and population served, primary health care clinics have often been targeted as a strategic channel through which to deliver various PA interventions. These PA interventions can be wide-ranging in terms of scope, health human resource utilization, and cost. Thus, identifying PA interventions that are effective, simple to administer, with low resource and cost implications potentially offers the greatest opportunity for uptake in the primary care setting. One such candidate PA intervention is a formal PA prescription issued by a prescriber (i.e., physician or nurse practitioner). Analogous to the way in which a medication is ordered, it is thought that a formal PA prescription might increase the likelihood of PA adoption by insufficiently active patients with minimal health human resource and cost implications to the clinic.

This review was therefore undertaken to assess the evidence for the clinical effectiveness of formal PA prescriptions issued by a physician or nurse practitioner for the primary prevention of chronic illness, specifically diabetes and cardiovascular disease, in otherwise healthy adults or in those with risk factors for the aforementioned diseases.

Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.

Copyright © 2014 Canadian Agency for Drugs and Technologies in Health.

Copyright: This report contains CADTH copyright material and may contain material in which a third party owns copyright. This report may be used for the purposes of research or private study only. It may not be copied, posted on a web site, redistributed by email or stored on an electronic system without the prior written permission of CADTH or applicable copyright owner.

Links: This report may contain links to other information available on the websites of third parties on the Internet. CADTH does not have control over the content of such sites. Use of third party sites is governed by the owners’ own terms and conditions.

Except where otherwise noted, this work is distributed under the terms of a Creative Commons Attribution-NonCommercial- NoDerivatives 4.0 International licence (CC BY-NC-ND), a copy of which is available at

Bookshelf ID: NBK264048PMID: 25535641


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