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Physicians’ perspectives on implementing the prevention scheme “Physical Activity on Prescription”: Results of a survey in Bavaria

Published:February 24, 2018DOI:https://doi.org/10.1016/j.zefq.2018.02.001

      Abstract

      The prevention scheme called “Rezept für Bewegung” (Physical Activity on Prescription, PAP) enables physicians to formally prescribe participation in health-oriented sports programs to their patients. The PAP scheme aims to strengthen the binding character of physicians’ patient counselling for physical activity. The research objective was to investigate the physicians’ awareness and their use of PAP as a prevention tool in patient counselling, as well as perceived barriers to implementation.
      A cross-sectional total population mail questionnaire survey was performed in two districts of Bavaria. 2,821 physicians in private practice were contacted; the response rate was 32.7 %. Descriptive data analysis of 923 questionnaires was carried out using SPSS.
      Only 26.4 % of the respondents (244/923) were familiar with the PAP scheme, and only 7.7 % (71/923) used PAP at least once a month when counselling their patients. Key barriers to implementation include lack of information on the prevention scheme, a limited choice of local matching sports programs and an unclear commitment of health insurances to reimburse patients for participation fees. Every third physician distrusts PAP to be an efficient way of improving physical activity in patients.
      To foster the implementation of PAP in the future, awareness-raising campaigns and an expansion of sports programs might be helpful. In order to strengthen the physicians’ confidence in the effectiveness of preventive patient counselling on physical activity, existing research evidence needs to be spread among physicians.

      Zusammenfassung

      Im Rahmen der Präventionsmaßnahme „Rezept für Bewegung“ können Ärzte ihren Patienten die Teilnahme an gesundheitsorientierten Sportangeboten auf Rezept verschreiben. Das Rezept für Bewegung zielt damit darauf ab, mehr Verbindlichkeit in der ärztlichen Präventionsberatung herzustellen. In der vorliegenden Studie wurde untersucht, ob niedergelassene Ärzte das Rezept für Bewegung kennen, wie sie es im Rahmen ihrer Patientenberatung anwenden und welche wahrgenommenen Barrieren sie für eine Umsetzung in der Praxis sehen.
      In einer Vollerhebung wurden in zwei bayerischen Regierungsbezirken 2.821 niedergelassene Ärzte mit einem standardisierten Fragebogen befragt. Bei einer Rücklaufquote von 32.7% konnten 923 Fragebögen in die deskriptive Datenanalyse mit SPSS eingeschlossen werden.
      Nur 26.4% der befragten Ärzte (244/923) kennen das Rezept für Bewegung und nur 7.7% (71/923) wenden das Rezept mindestens einmal im Monat im Rahmen ihrer Patientenberatung an. Hinderungsgründe sind vor allem fehlende Informationen über die Maßnahme, eine geringe Auswahl an passenden Sportangeboten vor Ort und die Unsicherheit, inwieweit die Krankenkassen die Teilnahmegebühren an Patienten rückerstatten. Jeder dritte Arzt bezweifelt, dass das Rezept für Bewegung ein effektiver Weg zur Förderung von körperlich-sportlicher Aktivität bei Patienten ist.
      Informationskampagnen zur Sensibilisierung der Ärzte und eine Ausweitung des Sportangebots scheinen deshalb sinnvolle Maßnahmen, um die Implementation des Rezepts für Bewegung zukünftig zu stärken. Ärzte sollten zudem gezielt über die Evidenz zu ärztlicher Präventionsberatung informiert werden, um ihre Zuversicht in die Effektivität ihrer Beratungsleistung zu stärken.

      Keywords

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