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GPs may be selling exercise referral schemes 'too hard', leaving patients with unrealistic expectations, researchers claim.

The study leaders said GPs and practice nurses needed

to strike a balance between promoting the benefits without being too unrealistic about the outcome or effort involved.

The study, based on 152 patients with hypertension, weight or stress problems referred for exercise in Hertfordshire, showed a drop-out rate of more than 50 per cent.

Of 127 patients who attended an initial fitness assessment at the leisure centre, just 105 patients actually started the exercise programme. Only 60 completed 24 sessions or more of exercise.

The authors said patients 'typically had high expectations' of the scheme, and those who finished the course had more modest expectations and came closer to achieving them than those who dropped out.

Study leader Dr Fiona Jones, senior lecturer in health and occupational psychology at the University of Leeds, said GPs should remind patients that benefits from exercise would be gradual and they should persist at it rather than raise patients' hopes too much.

She said: 'GPs should not be selling it too hard ­ stressing the benefits without being unrealistic. They should say it won't change your life but it will bring down blood pressure. Some people seemed to be expecting all sorts of wonderful changes.'

The results will appear in the British Journal of Health Psychology (September).

The Government has pledged to make exercise promotion a key plank in its fight against obesity in the public health White Paper. It estimated there were some 816

exercise referral schemes across the UK.

A Department of Health spokesperson said: 'It is crucial that patients are motivated to start and stick to their prescribed courses of exercise.

'Exercise referral is an intervention that has proven popular with health care practitioners and patients right across the country, and we expect this to continue.'

Dr Michael Gorman, a GP in Taunton, Somerset, who refers patients to a scheme in the area, said raising expectations too high could be detrimental, and GPs should set clear goals.

But Dr Colin Guthrie, a GP in Glasgow who took part in an early pilot on exercise referral, said: 'On the one hand, they want us to let our patients know about the benefits of exercise but they want us to select patients who are going to continue through with the scheme.

'How are we supposed to divine that? We are not divine beings.'

By Nerys Hairon

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