Comparative Effectiveness Study: Promoting Exercise in the Office

Questions:

  1. What is the variation in effectiveness between 3 methods of promoting exercise, as measured by patient self reported rates of exercise.
  2. Is there a difference in self-reported quality of life score?

Description:

Exercise has many recorded benefits, including improvements to: blood pressure, alzheimer’s, heart disease, diabetes, chronic back pain, depression, and mortality. Those benefits are often dose related, but even modest improvements in mild exercise are beneficial. One of the challenges, however, is getting people to change their behaviour and incorporate exercise into their week.

This study looks to compare the effectiveness of three different exercise promotion programs:

  1. Usual care: physician encouragement during the visit.
  2. Single education group visit with exercise physiologist at community recreation centre.
  3. Exercise program at community recreation centre (12 week program).

Patients will be recruited by the office staff prior to a routine care. The patient’s chart will be flagged with a randomized reminder to the physician that they are to enroll / recommend one of the three options (100 patients will be enrolled / physician sequentially, 20 physicians involved in the study. n = 2000). Patients will be randomized to to receive an invitation to one of the three arms and this will be documented. Patients will consent to follow up.

Patients will be asked (by phone by the MOA) in follow up interviews (at 4, 12, 26, and 52 weeks) to describe their exercise activities in the preceeding two weeks. To be defined by average # of minutes / week and average intensity (e.g. 90 minutes of mild exercise). These findings will be documented in the EMR.

Intention to treat analysis will be performed.

 

Example Output

  • Table of patient characteristics by arm with comparison stats to show similarity / differences: age, gender, # of problems, exercise rates.
  • Graph comparing exercise rates over time by intervention (with error bars)
  • Graph comparing quality of life scores over time by intervention.
  • Analysis by # of medical problems

 

Expected Data Requirements:

  • Patient Gender
  • Patient Age
  • Location (partial postal code)
  • Provider
  • Problem Lists
  • Baseline information:
    • height
    • weight
    • exercise survey (TBD)
    • quality of life survey (TBD)
  • Which Intervention Arm the patient is in
  • Participation in intervention (did they attend or not)
  • Exercise survey at: 4, 8, 12, 26, 52 weeks.
  • Quality of Life Survey at: 4, 8, 12, 26, 52 weeks.

 

NOTE: This example study could be expanded in the future to include PHR collected data.

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