Increasing Physical Activity in Primary Care Andrew Murray GP and Scottish Government Increasing Physical Activity in Primary Care Andrew Murray GP and Scottish Government

Life expectancy trends Portugal Scotland

Trends in male life expectancy: Scotland Richest 20% Poorest 20%

Albert Einstein Insanity “is doing the same thing over and over again and expecting different results”

SMOKADIABESITY

Risk Factors- mortality Blair et al BJSM 2009

Elderly Population less active Scotland (males) 25-34yo- 63% active 65-74yo- 24% active 75yo plus- 13% active Female population even worse

Risk reduction associated with physical activity- preaching to the converted!! Chronic conditionRisk reduction All cause mortality30% risk reduction CVD, stroke20-35% reduction Diabetes30-40% reduction Hip fractures36-68% reduction Colon cancer30% reduction Breast cancer20% reduction Loss of function30% reduction Depression/dementia20-30% reduction

MYTHBUSTING Too old to exercise Too Fat to exercise I’m diabetic, have OA, COPD, high BP, etc etc Regular physical activity actually helps treat these conditions

Persistence hunting

Investments that work 1.Whole of school programmes- early input to produce active ageing!! 2.Transport policies and systems that prioritise walking, cycling and public transport 3.Urban design that provides for equitable and safe access for recreational physical activity 4.Physical activity and NCD prevention integrated into primary health care systems 5.Public education, including mass media to raise awareness and change social norms on physical activity 6.Community-wide programs that mobilize and integrate community engagement and resources 7.Sports systems and programs that promote ‘sport for all’ and encourage participation across the life span.

NHS- how we deliver Embed it into the NHS- make it normal Education- integrate into CPD, workforce development, post and undergraduate curriculums Health promoting Health Service

CMO guidelines Known by 13% GP’s, 9% PN, 7% HV 30 mins 5x per weeks (or 150 mins total) moderate exercise- adults 60 mins daily for kids

Embed it into the Primary Care Ask the question?? “How many days a week do you do physical activity, and for how long” ??150 mins Assess Advice (Intervention) Direct to resources

Primary Care pathway Feasibility study Jan 2013 Roll out when success proved Applicable to secondary care, and other professional groups also Announced by Ms Robison in parliament

Brief interventions in Primary Care Physical Activity £ Smoking £ Statin >£10k

Education 40% of med schools teach CMO guidelines Share information Guidelines Grand rounds 23 and a half hours

Outcome aims 50% adults active by % children Increase life expectancy by 5 years in 10 years Decrease health inequalities Less spend on scripts, appointments

Life expectancy trends Portugal Scotland

Life expectancy trends

Resources in-fyss/ Physical Activity in the Treatment of disease in-fyss/ 23 and a half hours Active Scotland Take