Who is not adhering to physical activity referrals, and why?

Scand J Prim Health Care. 2011 Dec;29(4):234-40. doi: 10.3109/02813432.2011.628238.


Objective: To analyse patients' self-reported reasons for not adhering to physical activity referrals (PARs).

Design and setting: Data on 1358 patients who did not adhere to PARs were collected at 38 primary health care (PHC) centres in Sweden.

Intervention: PHC providers issued formal physical activity prescriptions for home-based activities or referrals for facility-based activities.

Subjects: Ordinary PHC patients whom regular staff believed would benefit from increased physical activity.

Main outcome measure: Reasons for non-adherence to PARs: "sickness", "pain", "low motivation", "no time", "economic factors", and "other".

Results: Sickness and pain were the most common motives for non-adherence among older patients. The youngest patients blamed economic factors and lack of time more frequently than those in the oldest age group. Economic factors was a more common reason for non-adherence among those referred for facility-based activities compared with those prescribed home-based activities. Low motivation was a more frequent cause of non-adherence among those prescribed home-based activities compared with those referred for facility-based activities. Furthermore, lack of time was a more common reason for non-adherence among patients issued with PARs due to high blood pressure than other patients, while low motivation was a more common reason among patients issued with PARs because of a BMI of > 25.

Conclusion: The reasons for non-adherence differ between patients prescribed home-based activities and referred for facility-based activities, as well as between patients with different specific characteristics. The information obtained may be valuable not only for the professionals working in PHC, but also for those who work to develop PARs for use in different contexts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Exercise Therapy* / economics
  • Exercise Therapy* / psychology
  • Female
  • Follow-Up Studies
  • Health Promotion
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Motivation
  • Motor Activity*
  • Patient Compliance*
  • Prescriptions
  • Primary Prevention
  • Prospective Studies
  • Self Report