Identifying Patients at Risk for Cardiometabolic and Chronic Diseases by Using the Exercise Vital Sign to Screen for Physical Inactivity.

Abstract

Introduction: Physical inactivity is a major health risk factor for multiple chronic diseases and early death. Despite evidence supporting diet and physical activity behavioral counseling interventions, physical inactivity is rarely measured or managed in primary care. A need exists to fully explore and demonstrate the value of screening patients for physical inactivity. This study aimed to 1) compare health profiles of patients screened for inactivity versus patients not screened for inactivity, and 2) compare health profiles of inactive, insufficiently active, and active patients as measured by the Exercise Vital Sign screener.

Methods: The study sample comprised adult patients attending a well visit from November 1, 2017, through December 1, 2022, at a large midwestern university hospital. We extracted data from electronic medical records on exercise behavior reported by patients using the Exercise Vital Sign (EVS) questionnaire. We extracted data on demographics characteristics, resting pulse, encounters, and disease diagnoses from PCORnet Common Data Model (version 6.1). We used the Elixhauser Comorbidity Index to determine disease burden. We compared patients with complete and valid EVS values (n =7,261) with patients not screened for inactivity (n = 33,445). We conducted further comparisons between screened patients reporting 0 minutes (inactive), 1 to 149 minutes (insufficiently active), or ≥150 minutes (active) minutes per week of moderate-vigorous physical activity.

Results: Patients screened for inactivity had significantly lower rates of several comorbid conditions, including obesity (P < .001), diabetes (P < .001), and hypertension (P < .001) when compared with unscreened patients. Compared with insufficiently active and inactive patients, active patients had a lower risk of 19 inactivity-related comorbid conditions including obesity (P < .001), depression (P < .001), hypertension (P < .001), diabetes (P < .001), and valvular disease (P < .001).

Conclusion: These findings suggest inactive and insufficiently active patients are at increased risk for multiple inactivity-related chronic conditions. These findings further support existing recommendations that inactive patients receive or be referred to evidence-based lifestyle behavioral counseling programs.