Following a recent study that highlights the connection between physical activity and chronic disease, researchers at the University of Iowa are suggesting that all patients be asked about their levels of physical activity.
Under the direction of Lucas Carr, an associate professor in the Department of Health and Human Physiology, the study looked at the answers to a questionnaire that over 7,000 patients at the University of Iowa Health Care Medical Center filled out, indicating how active they were.
Preventing Chronic Disease released the study, “Screening Patients for Physical Inactivity Helps Identify Patients at Risk for Cardiometabolic and Chronic Diseases,” online.
Patients who reported the highest level of physical activity—that is, exercising moderately to vigorously for at least 150 minutes a week—were statistically significantly less likely to have 19 chronic conditions, such as diabetes, cancer, cardiovascular disease, and respiratory disease, according to the researchers’ analysis of the patients’ questionnaire responses.
The results also imply that individuals who report little to no activity over a given week—that is, those who are least active—are more likely to develop a chronic illness.
Based on those findings, the Iowa researchers also advise health care institutions to notify patients who are physically inactive and at the highest risk about health and wellness options.
Carr is the study’s corresponding author. “In our health care environment, there’s no easy pathway for a doctor to be reimbursed for helping patients become more physically active,” Carr adds. “And so, for these patients, many of whom report insufficient activity, we need options to easily connect them with supportive services like exercise prescriptions and/or community health specialists.”
According to the researchers, no medical system in the Midwest has asked patients about their physical activity, and the majority of hospitals in the US do not.
Carr collaborated with Britt Marcussen, a family medicine specialist at UI Health Care, to administer the survey to patients who were in for yearly wellness examinations. November 2017 to December 2022 was the study period.
Patients completed two questions on a tablet as part of the exercise vital sign survey, as the questionnaire is known:
“On average, how many days per week do you engage in moderate to vigorous exercise (like a brisk walk)?” 0–7 days
“On average, how many minutes do you engage in exercise at this level?”
Carr and his group suggest that all patients have access to the survey.
“A patient’s visit is unaffected because it usually takes less than 30 seconds to complete this two-question survey. However, it can provide us with a wealth of information regarding that patient’s general health,” explains Carr.
Additionally, the researchers contrasted the outcomes of almost 33,000 patients who were not given the survey in other parts of the hospital with those of patients who filled out the surveys. Based on an analysis of all patients’ electronic medical records, the researchers discovered that patients who completed the survey were younger and healthier than the patient group that did not receive the questionnaire.
Although there has long been evidence linking physical activity to a lower chance of developing chronic illnesses, the researchers believe the study emphasizes the need of asking patients about their levels of physical activity.
“We believe this finding is a result of those patients who take the time to come in for annual wellness exams also are taking more time to engage in healthy behaviors, such as being physically active,” Carr explains.
Carr’s team discovered that in a related study that was published in the Journal of Physical Activity and Health, insurance companies paid for medical professionals’ bills for exercise counseling almost 95% of the time.
“Our findings suggest the recommended physical activity billing codes are reimbursed at a high rate when providers submit them for reimbursement, which reinforces the idea to make physical activity surveys and counseling services available,” Carr explains.
The study’s first author is Cole Chapman, an assistant professor at the College of Pharmacy. Chapman gathered and examined the information from the patients’ electronic medical records. He joined the Pharmacy faculty in 2019 after graduating from Iowa with a bachelor’s and PhD degree.
