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Open AccessArticle

Patterning in Patient Referral to and Uptake of a National Exercise Referral Scheme (NERS) in Wales from 2008 to 2017: A Data Linkage Study

1
Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff CF10 3BD, UK
2
Swansea University Medical School, Swansea University, Swansea SA2 8PP, UK
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(11), 3942; https://doi.org/10.3390/ijerph17113942
Received: 15 May 2020 / Revised: 28 May 2020 / Accepted: 30 May 2020 / Published: 2 June 2020
(This article belongs to the Special Issue Exercise Referral and Social Prescribing for Physical Activity)
Exercise referral schemes have shown small but positive impacts in randomized controlled trials (RCTs). Less is known about the long-term reach of scaled up schemes following a RCT. A RCT of the National Exercise Referral Scheme (NERS) in Wales was completed in 2010, and the scheme scaled up across Wales. In this study, using a retrospective data linkage design, anonymized NERS data were linked to routine health records for referrals between 2008 and 2017. Rates of referral and uptake were modelled across years and a multilevel logistic regression model examined predictors of uptake. In total, 83,598 patients have been referred to the scheme and 67.31% of eligible patients took up NERS. Older adults and referrals for a musculoskeletal or level four condition were more likely to take up NERS. Males, mental health referrals, non-GP referrals and those in the most deprived groupings were less likely to take up NERS. Trends revealed an overall decrease over time in referrals and uptake rates among the most deprived grouping relative to those in the least deprived group. Findings indicate a widening of inequality in referral and uptake following positive RCT findings, both in terms of patient socioeconomic status and referrals for mental health. View Full-Text
Keywords: physical activity; public health; intervention; exercise referral; primary care physical activity; public health; intervention; exercise referral; primary care
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Morgan, K.; Rahman, M.; Moore, G. Patterning in Patient Referral to and Uptake of a National Exercise Referral Scheme (NERS) in Wales from 2008 to 2017: A Data Linkage Study. Int. J. Environ. Res. Public Health 2020, 17, 3942.

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