Physical activity on prescription (PAP): Costs and consequences of a randomized, controlled trial in primary healthcare

Abstract

Objectives. To analyse costs and consequences of changing physical activity behaviour due to the “Physical Activity on Prescription” (PAP) programme. Design. A randomized controlled trial with a four-month intervention, with comparison between intervention and control group. Intervention. The PAP programme, with exercise twice a week, education, and motivational counselling. Subjects. 525 sedentary individuals, 20–80 years (intervention group n = 268, control group n = 257), with lifestyle-related health problems. A total of 245 returned for the four-month assessment. Main outcome measure. Programme costs based on intention-to-treat estimations, direct and indirect costs of inactivity, and physical activity behaviour analysed with IPAQ (International Physical Activity Questionnaire), self-reported physical activity, and measures of functional capacity. Results. The intention-to-treat programme costs for the four-month programme period was SEK (Swedish Kronor) 6475 (€ [Euro] 684) for the intervention group and SEK 3038 (€ 321) for the control group. Of this, healthcare providers’ costs were 24% in the intervention group, and 31% in the control group. The physical activity behaviour was significantly improved in both groups, but no differences were found between the groups. Implications. The largest share of the PAP programme costs was the participants’ costs. Significant improvements were shown in physical activity behaviour in both groups, but no differences were found between the intervention and control groups. Due to many non-completers, the potential for improvements of the motivating assignment with sedentary individuals in primary healthcare is obvious. Long-term follow-up can determine the sustainability of the results, and can be used in a future cost-effectiveness analysis.