Secrets to Improving Patient Exercise Compliance

When it comes to patient exercise, the current trends are promising. Studies show that physicians increasingly recommend that their patients exercise to maintain a healthy lifestyle and thwart disease. According to the 2010 National Health Interview Survey, about one in three adults who saw their doctor were told to exercise or become more physically active.

The results show that:

  1. Women are more likely to receive exercise counseling.

  2. There is a steady rise in exercise advice being given to adults over age 85.

  3. Patients with chronic health conditions--including obesity, heart disease and diabetes--often receive the most advice.

Yet even though a large percentage of patients receive advice to exercise, how do we increase the rate of adherence to regular exercise?

More Than a Pep Talk

Research indicates that a small, occasional pep talk from a physician about exercise is not enough for a patient to adopt the healthy behavior habit long-term. Leading studies show that about 50% of adults who start an exercise program drop it within a few months. To meet the current exercise recommendation of at least 150-minutes of physical activity a week requires ongoing effort for the patient— and, quite often, for you, the physician, as well.

One study found that physicians who counsel about exercise generally speak about health benefits and exercise techniques for no more than three to five minutes per appointment. This brevity may be due to lack of organizational support, time, educational materials, and wellness training. However, this brevity might lead to patient assumptions that lifestyle behaviors related to exercising and eating well are insignificant to their overall health.

Healthcare professionals can better address common barriers to patient exercise compliance by receiving continuing education and training on physical activity, integrating fitness assessments into check-ups, and identifying local, supportive resources for their patients. By implementing specific interventions that promote exercise compliance, you can help to buoy your patients’ efforts and continually motivate them to meet their fitness goals.

Take an Individualized Approach

Educating patients about the critical role regular exercise plays in improving and maintaining health is paramount, but patients also need to be equipped with the tools to implement this advice. This means creating an action plan and an individualized approach that reinforces your physical activity recommendations.

According to a study in the Journal of Family Practice, exercise advice is most effective when physicians (1) present the counseling alongside of a specific stepwise and progressive plan, and (2) regularly follow up with patients. And the results are impressive: Creating a tailored fitness program can increase exercise compliance in overweight patients fivefold. If you lack the resources to create such plans, consider extending your reach by partnering with a wellness professional or by referring your patient to someone who can provide that support.

Some other effective exercise interventions to consider include goal-setting guidance, fitness contracts, and self-monitoring through journaling or activity-recording. Encouraging patients to explore physical activities that they enjoy, as well as customizing workouts at their personal fitness levels can also help motivate regular exercise. Fitness trainers and wellness professionals can help to demonstrate techniques, provide challenges, and vary exercise methods to fully engage their clients.   

Make Exercise an Ongoing Conversation

Effective exercise recommendations target patients and center around their specific health limitations, internal motivators, and supportive services that will drive success. Including action-oriented strategies in the conversation increases the likelihood that patients take their your exercise advice to heart. Providing fitness plans, assessments, and educational resources helps you improve your patients’ physical functioning and their quality of life. When exercise becomes part of an ongoing conversation, patients are much more likely to get active and stay that way.


* Co-authors: Melissa Elder and Dana Gottesman