Insufficient Reporting of Factors Associated with Exercise Referral Scheme Uptake, Attendance and Adherence: A Systematic Review of Reviews

Background: Exercise Referral Schemes (ERS) are prescribed programmes aimed at tackling physical inactivity and associated non-communicable disease. Inconsistencies in reporting, recording and delivering ERS make it challenging to identify what works, why, and for whom. Methods: PRISMA guided this narrative review of reviews. Fifteen electronic databases were searched for systematic reviews of ERS. Reviewers applied inclusion criteria and quality assessed via the AMSTAR tool. Data on uptake, attendance and adherence were extracted. Results: Eleven reviews met the inclusion criteria. AMSTAR quality was medium. Definitions of uptake varied within reviews. Uptake ranged from 35%-81%. Groups reported as more likely to take up ERS included, (i) females and (ii) older adults. Attendance was defined variably but ranged from 12%-49%. Men were more likely to attend ERS. Effect of medical diagnosis upon uptake and attendance was inconsistent. Exercises prescribed were unreported and therefore, adherence to exercise prescriptions was unreported. The influence of theoretically-informed approaches on uptake, attendance and adherence was generally lacking, however, self-determination, peer support and supervision support were reported as influencing attendance. Conclusions: There was insufficient reporting across studies about uptake, attendance and adherence. Complex interventions like ERS require consistent definitions, recording and reporting of these key facets, but this is not evident from the existing literature.