Physical activity for people with chronic conditions: a systematic review of toolkits to promote adherence

PurposeThe World Health Organisation (WHO) recommends that health professionals develop and implement "adherence counselling toolkits" to promote adherence to long-term therapies in people with chronic conditions. This prospectively registered review aimed to systematically identify and evaluate existing toolkits developed to promote adherence to physical activity in people with chronic conditions.Materials and methodsGrey literature and six e-databases were searched for studies investigating the use of "toolkits" to promote adherence to physical activity or exercise recommendations in people with chronic conditions (Medline, PsycInfo, EmCare, Cochrane, CINAHL Plus, Pedro). A two-stage screening process was completed by two independent reviewers.ResultsFive studies describing five toolkits were included. Three toolkits displayed all WHO recommended features, including information on adherence, a clinically useful way of using this information, and behavioural tools for maintaining habits. The included toolkits featured "adherence" to the intervention; however, this was not their primary aim. There were trends towards improved physical activity with some of the included toolkits.ConclusionsThere are a lack of rigorously developed toolkits that focus on adherence to physical activity in people with chronic conditions. Toolkits should be developed, tested, and implemented to improve adherence and outcomes for people with chronic conditions. Health outcomes for people with chronic conditions may be enhanced with a focus on adherence, however there are currently no rigorously developed toolkits that meet this need.Adherence counselling toolkits should be co-designed with stakeholders for use with people with specific chronic conditions.Adherence-focused toolkits should be developed, implemented, and evaluated to ensure they are feasible to use and beneficial for health professionals working with people with chronic conditions.