Data from the National Referral Database suggest exercise referral schemes (ERSs) do not deliver any meaningful change in health and well-being.
In the first analysis of its kind, researchers obtained data from 23,731 individuals participating in 13 different ERSs lasting six weeks to three months. Pre- to post-ERS changes in health and well-being outcomes were examined including body mass index (BMI), blood pressure, resting heart rate (RHR), short Warwick Edinburgh Mental Well-being Scale (SWEMWBS), World Health Organization-Five Well-Being Index (WHO-5), Exercise-Related Quality of Life scale (ERQoL) and Exercise Self-Efficacy Scale (ESES).
Estimates revealed statistically significant changes occurred compared with point nulls for BMI (−0.55 [95% CI, −0.69 to −0.41] kgm2), systolic blood pressure (−2.95 [95% CI, −3.97 to −1.92] mmHg), SWEMWBS (2.99 [95% CI, 1.61-4.36] points), WHO-5 (8.78 [95% CI, 6.84-10.63] points), ERQoL (15.26 [95% CI, 4.71-25.82] points) and ESES (2.58 [95% CI, 1.76-3.40] points). However, no significant changes were seen in relation to RHR (0.22 [95% CI, −1.57 to 1.12] fc) or diastolic blood pressure (−0.93 [95% CI, −1.51 to −0.35] mmHg).
Furthermore, comparisons of estimates against null intervals suggested the majority of outcomes did not improve meaningfully.
The findings suggest that ERSs are associated with significant changes in most health and well-being outcomes, but the size of the changes are not as clinically meaningful as would be hoped for.
The authors say the results support the need to consider ERSs and their implementation more critically using real-world data to understand how best to maximise their potential, particularly considering the known benefits of exercise and the reach of ERSs across the UK.