Do Quebec doctors recommend physical activity?

According to the World Health Organization, more than a quarter of the adult population is not sufficiently active and this proportion has increased in high-income countries. Doctors, considered reliable sources of information, can provide advice adapted to the state of health of their patients. But do doctors in Quebec have the time, during their consultations, to promote physical activity and has their advice evolved over the last decade?

These are the questions that Suzanne Laberge, professor at the School of Kinesiology and Physical Activity Sciences at the University of Montreal, Véronique Gosselin and Kim Lestage, graduates of this school, Miguel Chagnon, statistician at the Department wanted to answer. of mathematics and statistics from UdeM, and Claude Guimond, responsible for continuing education at the Federation of General Practitioners of Quebec, in a recent study.

The objective of this study was to analyze the frequency of advice given regarding physical activity by general practitioners in Quebec between 2010 and 2020. In 2010, 702 doctors completed a questionnaire on the frequency of promotion of activity physical activity with their patients, perceived obstacles, improvements to be made and their own sports practice. They also had to provide sociodemographic information. In 2020, this same questionnaire was repeated to see the evolution of their promotion of physical activity and 794 doctors then completed it.

While there has been a significant increase in the number of family doctors promoting physical activity in Quebec, it has been mainly oriented towards secondary prevention.

Physical activity in cases of depression and osteoarthritis

According to this study, the proportion of family doctors discussing physical activity with their patients increased significantly in 2020 for certain health conditions. For depression, this rate increased from 51 to 73%, while for osteoarthritis it increased from 38 to 51%. Similar increases were observed for low back pain (29 to 46%), chronic obstructive pulmonary disease or asthma (15 to 22%), and cancer (2.4 to 5.1%).

Suzanne Laberge highlights this increased promotion of physical activity among people with cancer: “Being in good physical condition could allow them to better respond to chemotherapy, radiotherapy and other treatments. However, there is room for significant improvement!”

Primary prevention neglected

However, sports prescription has decreased for overweight patients and those with metabolic syndrome as well as in the context of primary prevention. For overweight patients, the proportion increased from 85 to 80%, for those with metabolic syndrome from 74 to 69% and for primary prevention from 40 to 34%. “As for healthy patients, doctors unfortunately lack time when it comes to talking about physical activity, since their consultations are very short, lasting 15 to 20 minutes,” explains Suzanne Laberge.

Be active yourself to recommend more physical activity

The study does not show any significant difference between doctors according to their place of residence or their gender.

However, it reveals that the most experienced doctors are the most inclined to promote physical activity: 52% of doctors with more than 20 years of practice did so in 2010 and 53% in 2020. “It is worrying to note that the advice on physical activity in primary prevention has decreased, particularly among young doctors, who are less likely to promote physical activity in their routine consultations compared to their older peers,” mentions Suzanne Laberge.

Note also that the personal practice of physical activity by doctors is a predictor of the promotion of physical activity in 2010 as in 2020.

A systemic approach to promoting physical activity

Closer collaboration between kinesiologists and physicians as well as promotional materials for education and awareness were the top identified needs in 2010 and this demand increased from 62% in 2010 to 72% in 2020.

“Successful integration of physical activity promotion into clinical settings requires a systems approach including medical school curricula, community resources and physical activity promotion experts, as well as policies and public health programs,” says Suzanne Laberge, who teaches the physical activity promotion course at UdeM.

She emphasizes the importance of this favorable environment to encourage physical activity: “We must help individuals by working on physical, cultural and economic elements. These local living conditions are essential so that people can take care of themselves and engage in physical activity for their well-being and to prevent various diseases.”