How general practitioners approach physical activity in routine care: a qualitative study of video-recorded consultations.

Abstract

Background: Physical activity engagement is critical for improving health and wellbeing across nearly all patient health concerns. General practitioners (GPs) are well positioned to have discussions about physical activity due to the frequency with which they see their patients over long periods of time. This study aimed to explore how physical activity is really discussed in real-world GP-patient consultations.

Aim: To explore a) how physical activity is discussed in and b) the types of physical activity that are discussed in real-world GP-patient consultations.

Design & setting: A qualitative descriptive study using real world video-recorded consultations with Melbourne-based general practitioners.

Method: Secondary analysis of 43 video consultation data from four GPs held with the Digital Library repository at Monash University, Australia. Two researchers reviewed the consultations and analysed each consultation using descriptive content analysis.

Results: From the total consultations (n=43), 41.9% (n=18) discussed physical activity. Five consultations included a structured GP Management Plan which prompted physical activity questions for discussion. GPs had a patient-centred approach discussed a range of different types of physical activity which was tailored to the specific health needs of each patient. These included exercise prescription, general advice, aerobic exercise, functional movement and allied healthcare referrals.

Conclusion: GPs discuss PA with patients in opportunistic or systematic ways using a patient-centered approach. This study could be used as a foundation for establishing teaching resources for GPs, both in training and in professional development. Future studies could explore how PA discussions improve health outcomes over longer periods of time. This will contribute to understanding how, and if, PA is followed-up to further understand the effectiveness of these discussions.