As of March 1, 2017, the decree allows doctors to prescribe adjusted physical activity (APA) to patients suffering from long-term illness (ALD). This recognition of adapted sports as a treatment without the use of drugs will be used by ten to eleven million French people who suffer from about thirty chronic diseases that are recognized as ALD.
How is the regulation of custom sports implemented in practice?
In order to prescribe adapted physical activity, the doctor must fill in a special form in which he specifies the therapeutic goals required (weight control, improvement of muscle strength, improvement of cardiorespiratory capacity, etc.) and contraindications specific to the patient. He then directs it to local actors active in conducting adapted physical activity: sports educators in clubs, physiotherapists, psychometricians or occupational therapists.
With their form, patients can go to a sports club of their choice (provided it offers activities that suit their health) or, in certain cities, to the city hall if it has a patient guidance system (this is the case, for example, in Strasbourg). .
If he decides to go to a sports club, the patient is taken care of by an educator trained in APA who offers him a program of activities tailored to his specifics and goals set by the doctor. Regularly, the educator sends a report on the activities to the doctor who prescribes a medicine that keeps records of the achievement of goals.
What does a doctor base his APA advice on?
The advice of the doctor who prescribes the medicine is based primarily on the patient’s health condition: the disease, the desired therapeutic goals, the specific limitations (contraindications) of the patient, but also his tastes. Indeed, to ensure that the patient practices proper physical activity over a long period of time, which is the best guarantee of positive effects, the doctor asks his patient about his wishes, his possible past as an athlete, his preferences (individual or collective sports, indoor or outdoor sports). , for example) etc.
To support his recommendations, the doctor has a database, MedicoSport Sante, published by the French National Olympic and Sports Committee (CNOSF). This database lists, discipline by discipline, benefits, risks, adaptation methods, target audience, federations involved, etc.
Finally, the doctor’s advice is based on his knowledge of local resources in terms of sports clubs or other structures that offer APA activities.
Who pays for customized physical activity sessions?
The financial issue is the weak point of this new measure. Indeed, nothing is planned at the national level to reimburse these costs, nor is drug treatment. The state relies on local authorities (for example, regions under regional health programs) and complementary insurers (“mutuelles”) to fund this activity.
Depending on the cities and departments, financial aid schemes are sometimes offered to reimburse all or part of the costs, mainly for the first year of practice. For example, in Strasbourg, where the prescription sport was launched in 2012, about 1,500 people use it. Free first year, APA price is then determined by income. Financial assistance is provided by the city of Strasbourg, the Regional Health Agency, the local health insurance scheme, the University Hospital in Strasbourg, the council of the Bas-Rhin department, etc.
Costs generally remain modest, except for activities that require significant equipment.