in the treatment, prevention and management of mental and physical chronic conditions
Background:
Of the 4 million Australians with a diagnosed mental health condition (1) 59.8% have one or more chronic conditions (2) and can expect to live ten years less that other Australians. The rise in these combined cases of mental and physical multi and co-morbidities and how they will be treated and managed in the future is an important consideration for policy makers influencing primary care and allied health referral and rebate strategies over the next decade (1, 4, 6-7).
One viable and potentially effective treatment option that has been heavily researched and clinically proven for various specific chronic mental and physical conditions, is physical activity. When referring to specific clinical populations with chronic conditions, this area is often referred to as exercise medicine.
Physical inactivity is one of the two leading modifiable risk factors for chronic disease, the other being diet. 56% of Australians fail to complete enough activity (8, 12).
The Program:
The Exercise Medicine (EM) program was designed to develop an efficacious treatment protocol that was simple, repeatable and delivered effective doses of exercise medicine for individuals with one or more chronic mental or physical conditions. Consideration was given to the associated psychological barriers to exercise (22-24). The intervention incorporates the heavily researched modalities of EM and the psychological treatment modality of mindfulness and Cognitive Behavioural Therapy (CBT). (10, 22, 25).
Following initial triage including various assessments, consideration of symptom severity, and time commitments, patients were prescribed an eight- or twelve-week program whereby they attend an authorised exercise physiologist supervised session two to three times each week.
Primary results gleaned over a 24-month period support the primary objectives of the program. These results showed that EM intervention resulted in strong and frequent adherence to exercise (85.3%). It not only reduced blood pressure over time but improved motivation, self-perceptions and chronic mental and physical health condition indicators. In addition, the intervention increased the patient’s capacity to work during the life of the program.
The findings also revealed a statistically significant reduction in both stress and anxiety in assessed participants who had not previously been diagnosed with a mental health condition. As both stress and anxiety are indicators of future clinical mental health risk, these findings support the use of the intervention in the monitoring and prevention of the onset development of mental health rates in patients with chronic illnesses.
Patients who presented with primary mental health diagnoses experienced significant reduction in all three symptom scores for depression, anxiety and stress (Ref: Mental Health Data).
Our unique EM intervention provides an efficacious, conservative and patient-centred treatment approach to community based mental and physical chronic disease management.