Exercise as medicine: Physicians’ perceptions of physical activity and exercise for chronic diseases

BACKGROUND: Although physical activity and exercise (PAE) offer several health advantages in the management of non-communicable diseases (NCDs), its systematic implementation in medical practice remains questionable. The aim of the study was to investigate Greek physicians’ knowledge, attitudes, intentions, abilities, and behavior (KAIAB) towards PAE in the management of NCDs. METHODS: A nationwide, cross-sectional, online study was conducted (October 2022 - March 2023) in Greece via a new questionnaire, which was developed and pilot-tested at an earlier stage of the study. The questionnaire's link was distributed to participants by email through their Medical Association. We computed physicians’ KAIAB total scale score as the sum of their responses. The three levels of Bloom's cut-off points were modified and were used to classify physicians’ KAIAB levels towards PAE. RESULTS: The physicians’ KAIAB levels in PAE were expressed as mean values (MV) and standard deviations (SD) respectively (MV/SD), as follows: 11.5/3.32 (low knowledge), 134.8/17.20 (moderate attitudes), 33.8/5.63 (high intentions), 19.48/5.76 (low abilities), and 30.81/7.23 (moderate behavior). Cronbach's alpha varied from 0.796 to 0.930 to achieve a high internal consistency to the scales of the new questionnaire. CONCLUSIONS: Greek physicians definitely are willing to advise and prescribe PAE and demonstrate moderate attitudes and behavior on these issues that need further improvement. However, their knowledge and self-reported abilities are apparently low, particularly on PAE prescription. These results suggest that, in order to include PAE in medical practice, are needed future policies to develop strategies to promote physicians’ education and training to improve their knowledge and skills on PAE, the adoption of exercise prescription strategies, and the integration of PAE into health care services as an alternative way of preventing and treating chronic diseases and promoting public health. KEY MESSAGES: • The Greek physicians’ level of Knowledge and abilities in physical activity and exercise is low rendering their implementation in medical practice difficult for patients with non-communicable diseases. • Empowerment of physicians is crucial in order to integrate physical activity and exercise prescription into the standard medical care of non-communicable diseases and thus promote public health.