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Theme: Person-Centred Care
A multi-centred randomised controlled trial to investigate the effects of adding web-based coaching (e-coachER) to an exercise referral scheme as a way to increase uptake and sustained health enhancing physical activity for patients with chronic physical and mental health conditions.
The GP exercise referral scheme (ERS) is an established method whereby doctors can ‘prescribe’ exercise to patients with medical conditions such as obesity, hypertension, type 2 diabetes, osteoarthritis or a history of depression or low mood. Evidence suggests that such exercise is beneficial, both physiologically and psychologically, but that rates of uptake and ongoing engagement by patients may not be optimised, with no long-term change in physical activity.
This project is being led by Plymouth University Peninsula Schools of Medicine and Dentistry (with collaborators from Exeter, Birmingham, Southampton, Brunel, Edinburgh, Marjon and the Royal Cornwall Hospital NHS Trust) and has received £1.3million of funding from the National Institute for Health Research Health Technology Assessment Programme (NIHR HTA), project number HTA 13/25/20.
Patients in primary care for medical conditions, or with a history of depression, and who are deemed suitable for ERS, will be recruited to the trial from South West England, the West Midlands and Glasgow. Patients will either receive ERS on its own, or with access to e-coachER using the Lifeguide platform, which has been extensively tested for supporting other patients in Southampton and around the world. The e-coachER group will also receive technical support to ensure access to the internet and boost motivation and confidence to use the technology.
The primary objective will be for patients to achieve the public health weekly target of 150 minutes of moderate to vigorous physical activity by 12 months. The trial will also investigate whether or not the addition of e-coachER results in more patients taking up ERS and sticking with it for the full programme. There will also be an analysis of cost-effectiveness.
NHS Research Ethics Committee approval was granted (15/NW/0347) on 11th May 2015. The ISRCTN number is 15644451.
The project will last for 37 months from January 1st 2015, including a window of 15 months for recruitment into the trial from July 2015 in South West England (Plymouth, Devon & Cornwall), Birmingham and Glasgow.
Extensive development, testing and piloting of e-coachER took place prior to the trial, with input from Professor Lucy Yardley’s LifeGuide web-support platform group at Southampton University and Professor Adrian Taylor’s group at Plymouth University, with other co-applicants and patient and public involvement. In an initial phase the randomised controlled trial will start with 180 patients, and if targets are met the trial will move to the final phase where a further 1220 patients will be recruited.
It is hoped that, of those patients receiving e-coachER, at least 10 per cent more people will achieve a weekly target of 150 minutes of moderate to vigorous physical activity by 12 months, compared with usual exercise referral alone.
This would provide an option for local services to support their patients to increase physical activity with a significant health gain. The project is also interested in identifying what participants feel about e-coachER, if it increases physical activity after 12 months, and what they thought were the main ways in which this support was useful to them.
By email: firstname.lastname@example.org
By telephone: 07812 651805
Professor Adrian Taylor, Chair in Health Services Research at Plymouth University Peninsula Schools of Medicine and Dentistry, is overall Chief Investigator, and site Principal Investigator for the South West.
Professor Kate Jolly, Chair of Public Health and Primary Care at the University of Birmingham, is the site Principal Investigator for Birmingham.
Professor Nanette Mutrie, Chair in Physical Activity for Health at the University of Edinburgh, is the site Principal Investigator for Glasgow.