Enquête auprès des médecins généralistes sur leur expérience et leur avis en matière de prescription d’activité physique

[Prescribing habits of physical activity by cardiac physicians in Côte d'Ivoire]

Regular physical activity (PA) has multiple health benefits that contribute to the prevention and management of many non-communicable diseases such as cardiovascular disease. However, a large proportion of the world's population is not active enough to benefit its health. Despite the potential of physicians to increase the level of PA practice in both primary and secondary prevention, there appears to be little intervention in this direction during medical consultations. What is the situation in Côte d'Ivoire? We conducted a prospective study that focused on the description and analysis of the practice of PA awareness and prescribing of Côte d'Ivoire cardiologist physicians and to examine the extent to which their socio-cultural characteristicsdemographics, their personal PA practices, barriers and needs influenced their PA prescribing in primary or secondary prevention settings. The results showed a high rate of overweight and obesity (64 %) and a low level of PA (40 %). We noted a high rate of locating (90 %) and advising AP (92 %). High blood pressure (98 %) and obesity (94 %) were the major conditions for which physicians prescribed PA. They were mainly about walking (94 %) and through oral counselling (80 %). Among the brakes identified were mainly the lack of knowledge about PA prescribing, lack of consultation time and lack of motivation of patients in 48 %, 44 % and 34 % of cases respectively. In terms of the needs expressed to promote the prescription of PA, it was mainly the personal conviction of the physician of the interest of prescribing an PA (80 %), of the organization of training on the prescription of PA (78 %) and completion of patient handouts (56 %).

Prescription of Physical Activity by General Practitioners in Type 2 Diabetes: Practice and Barriers in French Guiana

BACKGROUND

General practitioners (GPs) are the major primary healthcare players in the management of type 2 diabetes. In addition to a well-balanced diet, physical activity (PA) appears as a necessary non-medicinal therapy in the management of diabetic patients. However, GPs emphasize several obstacles to its prescription. The aim of this study is to evaluate the practices, barriers, and factors favoring the prescription of PA in type 2 diabetic patients by GPs in French Guiana.

METHOD

We conducted a cross-sectional descriptive study using a questionnaire, designed to interview 152 French Guiana GPs and describe their practice in prescribing PA in type 2 diabetic patients.

RESULTS

Our results revealed that the prescription of PA as a non-medicinal therapeutic choice in the management of type 2 diabetes was practiced by 74% of the French Guiana GPs. However, only 37% of GPs responded that they implemented the recommendations; indeed, only one-third knew about them. The majority of GPs were interested in PA training, but only 11% were actually trained in this practice. The lack of structure adapted to the practice of PA and the lack of awareness of the benefits of PA in metabolic pathology appeared as the main obstacles to PA prescription.

CONCLUSION

This study highlights the importance of improving the training of GPs in the prescription of PA, the development of adapted PA structures, and collaboration between the different actors within the framework of the sport-health system in type 2 diabetes in French Guiana.

[Prescription of physical activity by general practitioners: The Biarritz Côte Basque Sport Santé experience]

INTRODUCTION

Physical inactivity represents a public health challenge because it is associated with an increased risk of chronic disease and premature death. The prescription of physical activity (PA) by general practitioners in the context of sports clubs was used to fight against physical inactivity.

METHODS

Since May 2015, the Biarritz Côte Basque Sport Santé (BSS) association has proposed a primary prevention scheme based on physical activity prescribed by a panel of voluntary general practitioners designed for inactive persons with no significant chronic diseases. Participants are referred either directly to a sports club in which they are managed by a trained sports instructor or initially to a BSS sport health educator, who proposes an interview and physical evaluation in order to choose the most appropriate sporting activity. PA (comprising a total of 15 activities) is prescribed for twelve weeks and each participant is evaluated at the end of this period. We report our experience with this programme after the inclusion of 200 individuals.

RESULTS

Eighty-six physicians from seventeen sites of the Basque coast area participated in this study. Two hundred persons received a PA prescription (men: 27%, mean age: 54 years, range: 18-80); 20% of them were referred directly to participating sports clubs and 80% were first evaluated by our BSS educator. Aquatic gymnastics was the PA most frequently chosen (23%). The number of affiliated sport clubs increased from seven at the beginning of our project to twenty five at the time of analysis. Twenty-eight sport instructors have now been trained and accredited to manage participants. One hundred and thirty eight subjects have completed the planned twelve-week schedule and have been evaluated: 90% of them continue their sport in the sports club.

DISCUSSION

Our experience suggests than general practitioner-based PA referral to well-trained sports club educators is a feasible strategy for managing physically inactive individuals. This protocol comprises an intermediary structure, the BSS unit, which allows evaluation and referral to adapted PA for each participant plus compliance monitoring. However, the long-term efficacy of this programme has yet to be evaluated.