Grice Adam, Izon Amy S, Khan Nada F, Foy Robbie, Beeken Rebecca J, Richards Suzanne H
Leeds Institute of Health Sciences, University of Leeds, Leeds.
Exeter Collaboration for Academic Primary Care, College of Medicine and Health, University of Exeter, Exeter.
Br J Gen Pract. 2025 Mar 27;75(753):e277-e284. doi: 10.3399/BJGP.2024.0166. Print 2025 Apr.
Clinical guidance recommends promoting physical activity during general practice consultations. The frequency and content of physical activity discussions in UK general practice are poorly understood.
To explore the content of physical activity discussions during routine consultations between patients and GPs.
Secondary analysis was undertaken of video-recorded UK general practice consultations from the One in a Million study, which was conducted in the West of England.
In total, 294 consultation transcripts were available; these were screened to identify consultations that included or omitted physical activity advice when recommended by National Institute for Health and Care Excellence guidance. The content, quality, and depth of advice provided by GPs were scored to ascertain how meaningful the advice was.
Physical activity was relevant to management according to clinical guidance in 175/294 (59.5%) consultations. In 64 (36.6%) of these consultations, physical activity was discussed as part of clinical management; the depth of discussion was judged as 'meaningful' in 22 (12.6%) consultations. Although physical activity advice tended to be given most often for musculoskeletal problems, depth of advice did not appear to be related to the presenting problem. When physical activity advice was relevant and omitted, consultations prioritised another overriding presenting problem, or clinical management focused on another intervention.
Physical activity advice, following national guidance, was potentially relevant to more than half of GP consultations; GPs delivered advice of varying depth in a third of these consultations. Future work should explore ways of delivering physical activity advice effectively, efficiently, and equitably within the constraints of general practice.
临床指南建议在全科医疗咨询中促进身体活动。英国全科医疗中身体活动讨论的频率和内容尚不清楚。
探讨患者与全科医生在常规咨询中身体活动讨论的内容。
对来自“百万分之一”研究的英国全科医疗咨询视频记录进行二次分析，该研究在英格兰西部进行。
总共获得了294份咨询记录；根据英国国家卫生与临床优化研究所的指南，对这些记录进行筛选，以确定包含或省略身体活动建议的咨询。对全科医生提供的建议的内容、质量和深度进行评分，以确定建议的意义有多大。
根据临床指南，在175/294（59.5%）的咨询中，身体活动与管理相关。在这些咨询中的64例（36.6%）中，身体活动作为临床管理的一部分进行了讨论；在22例（12.6%）咨询中，讨论深度被判定为“有意义”。尽管身体活动建议最常针对肌肉骨骼问题给出，但建议的深度似乎与就诊问题无关。当身体活动建议相关但被省略时，咨询优先考虑另一个首要的就诊问题，或者临床管理侧重于另一种干预措施。
遵循国家指南，身体活动建议可能与超过一半的全科医生咨询相关；全科医生在三分之一的此类咨询中提供了不同深度的建议。未来的工作应探索在全科医疗的限制范围内有效、高效且公平地提供身体活动建议的方法。
