Kee, Lee Ann
(2021)
The practice and factors that influence exercise prescription by primary care physicians in Hospital Universiti Sains Malaysia: a cross-sectional study.
Other.
Pusat Pengajian Sains Kesihatan, Universiti Sains Malaysia.
(Submitted)
Abstract
Physical activity (PA) provides a lot of benefits and can both prevent and manage chronic diseases. A doctor’s advice on PA for their patients is vital in medical care. The aim of this study is to investigate the knowledge, confidence, and physical activity levels of primary care physicians (PCPs) with regards to physical activity and exercise (PAE) counselling and exercise prescription in HUSM. Barriers and factors related to PCP’s practice of exercise prescription are also identified with a consideration of conditions like Covid-19 pandemic and the Movement Control Order (MCO) in Malaysia. PCPs (n=64) participated in this study through an online questionnaire distributed through the Family Medicine Department, Universiti Sains Malaysia, HUSM. PCPs provided information on their knowledge/training, current practices, confidence, and barriers in PAE counselling and exercise prescription in clinical practices. Sixteen PCPs stated they had formal education/ training in PAE and 48 reported no specific PAE training. Majority of PCPs (n=59) know the difference between physical activity and exercise compared to the rest who were unsure. During daily clinical practice, PCPs mentioned that on average, they provide physical activity and exercise (PAE) consults to patients about 49.7% of the time. Majority of PCPs (67.4%) feel confident and able to provide information and advice on PAE during clinic sessions. The most prominent barriers to clinical PAE practice were the lack of exercise education (3.7/5.0 score, r=0.47), patients preference of pharmaceutical interventions (3.5/5.0 score, r=0.45) and the lack of continuing education on PAE in medical school and housemanship (4.0/5.0 score, r=0.37) , at p<0.001. Other significantly correlated barriers to practice includes the lack of standard guideline on providing PAE consultations during clinical visits (4.0/5.0 score, r=0.32) and noted
that PCPs need for more personal knowledge (4.6/5 score, r=0.25). There was a significant effect of PCPs’ PA levels to the practice of recommending PAE, F=4.87 (p<0.05) from the one-way ANOVA analysis. Overall, majority of PCPs counselled on PAE for about half the times during their clinical sessions. PCPs that are physically active tend to advise more of their patients on exercise and the barriers on recommending PAE during clinical sessions were mainly due to insufficient PAE knowledge and department guidelines. Hence, future research could investigate on methods to improve PAE counselling by PCPs to encourage a more physically active lifestyle for their patients.
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