Implementation Of Physical Activity Prescription For People With Non-communicable Diseases In Ile-de-France

Abstract

Purpose: Recognized by law in 2016, the prescription of PA for people with NCDs is promoted and implemented by the regional state sports and health offices. The "Prescri'forme" plan aims to increase the use of PA as non-drug therapy for NCDs. Based on the implementation of the Ile-de-France program and its surrounding context, the objective of this evaluation was to identify the obstacles and benefits related to the integration of PA into the healthcare system of patients with NCDs. METHODS: Through the review of the scientific literature, institutional reports, and grey literature on the recognition and development of PA within public health policy, 21 semi-directed interviews identified challenges and difficulties in the implementation of the "Prescri'forme" plan. Particular attention was given to the changes currently happening within the organisation of the healthcare system, in order to propose a method to integrate PA into the healthcare system for patients with NCDs. RESULTS: The deployment of the plan is still in progress, with its advances varying based on location, affected largely by the maturity of the PA prescription-practice systems already in place and the strength of the links established between the actors. For example, a program to provide support and guidance for the prescription and supervision of adapted PA. In Ile-de-France, local coordination is gradually being established. At a regional level, there is a lack of support for steering the system, particularly to gather data from patient follow-up visits in order to demonstrate more robustly the value of integrating PA into the care of these patients. In addition, a regional level of coordination would provide a space for exchange between actors involved with promoting PA as part of the healthcare system. CONCLUSION: To strengthen the legitimacy of PA in the care of patients suffering from NCDs, it is necessary to link PA prescription systems with organizational changes already in progress in the healthcare system. The desire to provide a flat-rate coverage for NCDs represents an opportunity to propose models of a healthcare system that integrates PA. These models must demonstrate the benefits of these programs in terms of public health, medicine, and economics, whilst also responding to the challenges around prescription pricing and PA dispensation.