General Practitioners' beliefs about physical activity for managing depression in primary care

Objectives
Clinical guidance recommends physical activity for patients with persistent sub-threshold depressive symptoms or mild to moderate depression. However, little is known regarding how General Practitioners (GPs) view physical activity as a treatment for depression.

This is the first study to explore GPs’ views of physical activity, the extent of promotion of physical activity within the course of consultations, and awareness of evidence and clinical guidance for physical activity as a treatment for depression.

Methods
Qualitative study using semi-structured interviews with 15 General Practitioners from practices participating in a randomised controlled trial of facilitated physical activity for depression in primary care.

Results
Most GPs felt that physical activity could be an effective treatment for depression but referred to anecdotal rather than research evidence to support its promotion in primary care. Most GPs thought that physical activity was best promoted as an adjunct to antidepressant medication. GPs also stated that many patients were looking for alternative approaches to treating depression but were also aware of many barriers to physical activity.

Conclusion
GPs are enthusiastic about promoting physical activity for the management of depression and may do so without reference to an evidence base. The findings have implications for clinical guidelines regarding the recommendation of physical activity for patients with depression. GPs should explore both patients’ perceptions of physical activity as a treatment and their ability to engage with physical activity prior to recommending physical activity for the management of depressive symptoms in primary care.

Highlights
► GPs are enthusiastic in promoting physical activity for managing depression. ► GPs promote physical activity despite awareness of evidence and guidelines. ► GPs believe physical activity has biochemical, social and psychological benefits. ► GPs are aware of the need for patient autonomy and a reduced reliance on medication.