Are primary care physicians in Singapore prescribing the best medicine - physical activity?

Introduction: Physical activity has been shown to offer numerous benefits in improving mortality and morbidity outcomes. However, the specifics of advising and/or prescribing exercise in patient management may not be taught comprehensively in undergraduate and postgraduate medical curriculum. This study aimed to evaluate primary care physicians' habits in advising and/or prescribing exercise to their patients.

Methods: Primary care physicians practising in all public primary care clinics in Singapore were invited via email and posters to participate in an anonymous online questionnaire. The questionnaire explored physicians' habits in advising and/or prescribing exercise to their patients.

Results: Results showed that 95.9% of primary care physicians gave patients advice on exercise. However, only 24.7% prescribed exercise (specific written instructions) to their patients. Time constraint is the top barrier cited by primary care physicians for not giving exercise advice and/or prescription. The top three conditions for which exercise advice and/or prescription was given by physicians were diabetes mellitus, dyslipidaemia and hypertension. Physicians who cited insufficient expertise/knowledge as a barrier were more likely to have never attended an exercise prescription course.

Conclusion: Most primary care physicians in Singapore advised exercise as part of the management plan for their patients. However, a much lower proportion gave specific exercise prescription. The most commonly cited barrier to advising or prescribing exercise is time constraint, while lack of expertise or knowledge may stem from not having received relevant training. Future efforts could focus on providing primary care physicians with targeted training to overcome the barrier of insufficient expertise or knowledge in exercise advice and prescription.