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Physical activity on prescription in accordance with the Swedish model increases physical activity: a systematic review
  1. Aron Onerup1,
  2. Daniel Arvidsson2,
  3. Åse Blomqvist3,
  4. Eva-Lotte Daxberg4,
  5. Lennart Jivegård5,
  6. Ingibjörg H Jonsdottir6,
  7. Stefan Lundqvist3,
  8. Anders Mellén7,
  9. Josefine Persson8,
  10. Petteri Sjögren5,
  11. Therese Svanberg9,
  12. Mats Borjesson2,10
  1. 1 Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  2. 2 Department of Food and Nutrition and Sport Science, Centre for Health and Performance, University of Gothenburg, Gothenburg, Sweden
  3. 3 Närhälsan FaR-teamet Gothenburg, Västra Frölunda, Region Vastra Gotaland, Sweden
  4. 4 Medical Library, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
  5. 5 HTA-centrum, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden
  6. 6 Institute of Stress Medicine, Gothenburg, Sweden
  7. 7 Department of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden
  8. 8 Health Metrics, Goteborgs Universitet Sahlgrenska Akademin, Gothenburg, Sweden
  9. 9 Medical Library, Sahlgrenska University Hospital, Gothenburg, Sweden
  10. 10 Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
  1. Correspondence to Dr Aron Onerup, Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg 41685, Sweden; aron.onerup{at}


Objectives This study investigates the effects of the core elements of the Swedish model for physical activity on prescription (PAP) by evaluating studies that compared adults who received PAP with adults who did not receive PAP. All participants were adults identified by a healthcare professional as in need of increased physical activity. Primary outcome was level of physical activity.

Design Systematic review.

Eligibility criteria (1) Published 1999. (2) Systematic review, randomised controlled trial (RCT), non-RCT or case series (for adverse events). (3) ≥12 weeks’ follow-up. (4) Performed in the Nordic countries. (5) Presented in English, Swedish, Norwegian or Danish.

Data sources Systematic searches in PubMed, Embase, the Cochrane Library, AMED, CINAHL and SweMed+ in September 2017. Included articles were evaluated using checklists to determine risk of bias.

Results Nine relevant articles were included: seven RCTs, one cohort study and one case series. Primary outcome was reported in seven articles from six studies (five RCTs, one cohort study, 642 participants). Positive results were reported from three of the five RCTs and from the cohort study. No study reported any negative results. Swedish PAP probably results in an increased level of physical activity (GRADE⊕⊕⊕Ο).

Conclusions Although the number of the reviewed articles was relatively modest, this systematic review shows that PAP in accordance with the Swedish model probably increases the level of physical activity. As a model for exercise prescription, Swedish PAP may be considered as part of regular healthcare to increase physical activity in patients.

  • evidence-based review
  • exercise
  • health promotion
  • non-communicable disease
  • public health

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  • Contributors MB had the idea for the article. TS and ELD performed the literature search. All authors performed the literature appraisal. AO and MB wrote the article with all coauthors contributing input. MB is the guarantor. All authors revised and approved the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AO, AM, IHJ, SL and MB have authored chapters in FYSS (a Swedish evidence-based book that summarises the effect of physical activity on various medical conditions). ÅB, IHJ, SL, AM and MB are members of the therapy group on physical activity in the medical committee of Region Västra Götaland. MB is member of the board of YFA (Swedish professional associations promoting physical activity), the organisation that has developed Swedish PAP. ÅB and SL participate regularly as educators on how to use the Swedish PAP method.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data are available in the published HTA report at The checklists used for critically assessing included articles can be downloaded at Checklists translated into English may be requested by contacting the corresponding author.

  • Correction notice This article has been corrected since it published Online First. The seventh author’s name has been corrected to Stefan Lundqvist.