Evidence map›Paper›PMID 22577180›Full record

Trial reportJournal of epidemiology and community health2012

An evaluation of the effectiveness and cost effectiveness of the National Exercise Referral Scheme in Wales, UK: a randomised controlled trial of a public health policy initiative.

Simon Mark Murphy, Rhiannon Tudor Edwards, Nefyn Williams, Larry Raisanen, Graham Moore, Pat Linck, Natalia Hounsome, Nafees Ud Din, Laurence Moore

Erratum issuedOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of epidemiology and community health, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 67 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 17 pooled it
7.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 17 syntheses or guidelines pooled it, 202 citations in OpenAlex.

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  4. A systematic review and narrative synthesis of physical activity referral schemes' components.The international journal of behavioral nutrition and physical activity · 2023
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  6. Exercise-based cardiac rehabilitation for coronary heart disease.The Cochrane database of systematic reviews · 2021
    Pooled it
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  13. Exercise-based cardiac rehabilitation for coronary heart disease.The Cochrane database of systematic reviews · 2016
    Pooled it
  14. Exercise as Treatment for Anxiety: Systematic Review and Analysis.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2015
    Pooled it
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  16. Exercise for depression.The Cochrane database of systematic reviews · 2013
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  18. Trial
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7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

  • Erratum issued
5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Simon Mark MurphyDECIPHer, Cardiff School of Social Sciences, Cardiff University, Cardiff, Wales, UK. murphys7@cf.ac.ukre
Rhiannon Tudor Edwards
Nefyn Williams
Larry Raisanen
Graham Moore
Pat Linck
Natalia Hounsome
Nafees Ud Din
Laurence Moore
Cardiff University · GBBangor University · GBPrimary Health Care · QA

Funding

British Heart FoundationCancer Research UKWellcome Trust WT087640MA
6 · The paper itself

Abstract

backgroundThe Wales National Exercise Referral Scheme (NERS) is a 16-week programme including motivational interviewing, goal setting and relapse prevention.

methodA pragmatic randomised controlled trial with nested economic evaluation of 2160 inactive participants with coronary heart disease risk (CHD, 1559, 72%), mild to moderate depression, anxiety or stress (79, 4%) or both (522, 24%) randomised to receive (1) NERS or (2) normal care and brief written information. Outcome measures at 12 months included the 7-day physical activity recall, the hospital anxiety and depression scale.

resultsOrdinal regression identified increased physical activity among those randomised to NERS compared with those receiving normal care in all participants (OR 1.19, 95% CI 0.99 to 1.43), and among those referred for CHD only (OR 1.29, 95% CI 1.04 to 1.60). For those referred for mental health reason alone, or in combination with CHD, there were significantly lower levels of anxiety (-1.56, [corrected] 95% CI -2.75 to -0.38) and depression (-1.39, [corrected] 95% CI -2.60 to -0.18), but no effect on physical activity. The base-case incremental cost-effectiveness ratio was £12,111 per quality adjusted life year, falling to £9741 if participants were to contribute £2 per session.

conclusionsNERS was effective in increasing physical activity among those referred for CHD risk only. Among mental health referrals, NERS did not influence physical activity but was associated with reduced anxiety and depression. Effects were dependent on adherence. NERS is likely to be cost effective with respect to prevailing payer thresholds. Trial registration Current Controlled Trials ISRCTN47680448.

Indexed as

Health PolicyReferral and ConsultationAdolescentAdultAgedAnxiety DisordersCase-Control StudiesCoronary DiseaseCost-Benefit AnalysisDepressive DisorderExercise TherapyFemaleHealth PromotionHumansMaleMiddle Aged

Identifiers

PMID22577180
PMCPMC3402741
OpenAlexW2118385537

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.