Physician Referrals and Patient Sex are Associated With Higher Completion Rates in Exercise Referral Schemes
Carson Halliwell, Renaud Tremblay, Jonathon Fowles, Ryan E.R. Reid, Rebecca Moyer, Taniya S. Nagpal, Myles W. O’BrienIntroduction:
Physical inactivity is a global health issue, and exercise referral schemes (ERS) are a strategy to increase physical activity through primary care. This study aimed to examine whether the referring practitioner influences ERS initiation and completion, and whether these differ between male and female participants.
Methods:
Data from 30,303 adults (68% female; mean age 51 ± 16 yr) referred to ERS were analyzed using the National ReferAll Cohort. Participants were referred by a physician, nurse, physiotherapist, or general health professional (e.g., Health Trainer, Healthcare Assistant, etc.). Logistic regression models estimated the odds of i) starting but not completing the ERS, and ii) completion of the prescribed ERS, adjusting for age, participant sex, ERS type, and duration. Interactions of referrer type × participant sex were examined.
Results:
Overall, 47% completed their ERS, 24% left early, and 29% did not start. Compared with physician referrals, nurses (odds ratio (OR) = 0.87,
Conclusion:
Addressing the sex-based initiation-completion gap and increasing physician referrals may improve ERS retention, while both sexes show lower completion when referred by general health professionals, highlighting the need for targeted referral strategies.