![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
Abstract
Background
Although physical activity (PA) is key in the management of type 2 diabetes (T2DM) and hypertension, it is difficult to implement in practice.
Methods
Cross-sectional, observational study. Participating physicians were asked to recruit two active and four inactive patients, screened with the Ricci-Gagnon (RG) self-questionnaire (active if score ≥16). Patients subsequently completed the International Physical Activity Questionnaire. The objective was to assess the achievement of individualized glycated hemoglobin and blood pressure goals (<140/90 mmHg) in the active vs inactive cohort, to explore the correlates for meeting both targets by multivariate analysis, and to examine the barriers and motivations to engage in PA.
Results
About 1,766 patients were analyzed. Active (n=628) vs inactive (n=1,138) patients were more often male, younger, less obese, had shorter durations of diabetes, fewer complications and other health issues, such as osteoarticular disorders (P<0.001 for all). Their diabetes and hypertension control was better and obtained despite a lower treatment burden. The biggest difference in PA between the active vs inactive patients was the percentage who declared engaging in regular leisure-type PA (97.9% vs 9.6%), also reflected in the percentage with vigorous activities in International Physical Activity Questionnaire (59.5% vs 9.6%). Target control was achieved by 33% of active and 19% of inactive patients (P<0.001). Active patients, those with fewer barriers to PA, with lower treatment burden, and with an active physician, were more likely to reach targets. The physician’s role emerged in the motivations (reassurance on health issues, training on hypoglycemia risk, and prescription/monitoring of the PA by the physician). A negative self-image was the highest ranked barrier for the inactive patients, followed by lack of support and medical concerns.
Conclusion
Physicians should consider PA prescription as seriously as any drug prescription, and take into account motivations and barriers to PA to tailor advice to patients’ specific needs and reduce their perceived constraints.
Acknowledgments
This work was funded by Novartis Pharmaceuticals Corporation. The authors would like to thank all the patients and investigators at participating sites, and Felicity Neilson for her valuable suggestions to improve this article.
Disclosure
M Duclos has received fees for consultancy, advisory boards, conference, travel, or accommodation from Novartis, Novo-Nordisk and Sanofi. N Postel-Vinay has received fees for clinical investigations from Novartis. S di Nicola is shareholder in Inferential, a provider of biostatistical consulting services working with pharmaceutical companies including Novartis. B Fiquet, S Quéré and S Dejager are employees of Novartis Pharma SAS. The authors report no other conflicts of interest in this work.