Promoting physical activity in general practice: should prescribed exercise be free?

In the UK there are numerous schemes whereby general practitioners can pres cribe exercise programmes, usually based in leisure centres. Of the factors that discourage adherence to such programmes in the USA, cost has proved i mportant. We collected demographic and questionnaire data from 152 inner-Lo ndon patients (108 women, 44 men) before they started an exercise programme on a National Health Service prescription, and analysed the results accord ing to whether they dropped out of the programme (78%) or not. Use of logistic regression revealed only one previous barrier to exercise, 'not knowing about local exercise facilities', as a significant positive de terminant of adherence (adjusted odds ratio 3.51, 95% confidence interval, 1.04 to 11.86). For 'lack of money' patients were more likely to drop out o f the programme (adjusted odds ratio 0.25, 95% ct 0.07-0.85). The very low cost of participation in this scheme, did not encourage adhere nce, particularly by those who had cited 'lack of money' as a previous barr ier. The case of making prescribed exercise free or even low-cost remains u nproven.