As the medical industry shifts its focus to preventative interventions rather than treatment, patients could leave doctor’s consultations with a fundamentally different prescription that instructs them to, for example, take “moderately intense aerobic exercise for 30 minutes, five times a week,” or “vigorously intense aerobic exercise for 20 minutes, three times a week.” This is according to a statement issued by Discovery Vitality at the launch of its new Discovery Vitality Active Rewards Programme, which incentives doctors to get active and healthier.
During a round table discussion at the launch, a panel of South Africa’s leading experts and researchers shared the latest findings around exercise and how this underestimated but potent behaviour is set to dramatically change the face of healthcare.
Modelled on the popular Vitality Active Rewards Programme, the initiative, which supports the drive for healthier doctors and healthier patients, is based on Discovery Health’s research that shows a clear correlation between the health of a doctor and the health of their patients. The programme aims to reward doctors for taking care of their own health. According to Chief Medical Officer at Discovery Health, Dr Maurice Goodman, healthier doctors are more productive, deliver better quality care, and are more effective in prescribing wellness interventions to their patients.
“The explosion in wearable devices that track heart rate and other variables has made monitoring patient activity levels that much easier for doctors,” said Dr Goodman.
Sedentary lifestyles a burden on the health system
The development comes amidst scientific and medical evidence that highlight insufficient physical activity as a key risk factor for non-communicable diseases (NCDs) such as cardiovascular diseases, cancer and diabetes. Despite the medical research showing the benefits of exercise, Dr Goodman says over the past 25 years the incidence of NCDs in SA has increased dramatically and three-fold when it comes to diabetes in particular.
A recent Stats SA paper has reported that NCDs are now the leading cause of mortality in SA over communicable diseases, HIV/AIDS and TB. While research published in the South African Medical Journal showed that severe obesity increased healthcare expenditure by R4,425 per person, split between inpatient and outpatient care. In South Africa, obesity is ranked as one of the top five risk factors for early death and years lived with disabilities.
Exercise: the prescription of the future
According to the panel, exercise is a key indicator of health that’s already changing the face of global healthcare. Head of Vitality Wellness, Dr Craig Nossel, says that one of the most powerful antidotes to the devastating tsunami of chronic diseases of lifestyle is as astoundingly simple as doctors prescribing and monitoring their patients’ physical activity long-term. “We need to get doctors to advise their patients to eat better and get moving as well as facilitate their health journey,” said Dr Nossel.
While GP and CEO of the South African Medical and Dental Practitioners, Dr Elijah Nkosi, says he has seen positive outcomes from prescribing exercise to his patients and tailoring it to their needs.
The prescription for exercise for the general population is 150 minutes of moderate intensity or 75 minutes of high intensity exercise a week. However, Cardiologist and President of the Johannesburg Branch of the SA Heart Foundation, Dr David Jankelow, says recent studies have shown that even people who exercise only on weekends reap the health benefits.
“We as clinicians have to be much stronger from an advocacy point of view. Exercise may be more important than medicine when it comes to preventing and sustaining health,” said Dr Jankelow.
Rewarding active lifestyles a catalyst for change
“Our evidence shows that incentivising physical activity leads to habit-formation, where the behaviour continues even when the incentive is removed,” explained Nossel. “We know that personalised and tailored interventions are more effective at changing behaviour than impersonal generic ones.”
“Guided by behavioural economics theory, Vitality Active Rewards recognises individual fitness levels and rewards members for reaching personalised targets,” explains Dr Nossel. “These rewards are reset weekly in line with the previous weeks’ achievements to ensure slowly increasing targets towards ever-better health and fitness for members.”
Discovery Vitality’s data shows an increase of 78.5% in activity levels one year after members joined the Vitality Active Rewards programme. This trend is particularly apparent among members with chronic diseases such as high blood pressure or diabetes. These members increased their physical activity levels by a substantial 78% after joining Vitality Active Rewards, substantially impacting their health for the better.