Key result
Active status on the Exercise Vital Sign is linked to lower risk of 19 inactivity-related comorbidities.
Why the study?
Physical inactivity is rarely measured or managed in primary care despite being a major risk factor for chronic diseases, creating a need to demonstrate the value of screening patients for physical inactivity.
Does screening for physical inactivity using the Exercise Vital Sign identify differences in cardiometabolic and chronic disease burden in adult primary care patients?
Observational (n=40,706)
No
Does screening for physical inactivity using the Exercise Vital Sign identify differences in cardiometabolic and chronic disease burden in adult primary care patients?
p-value: p=<.001
Screening for physical inactivity using the Exercise Vital Sign effectively identifies patients at higher risk for multiple cardiometabolic and chronic conditions, supporting its routine use in primary care.
Supports Exercise Vital Sign screening for cardiometabolic risk stratification; leaves open prospective outcome benefits.
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.
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Chapman et al. (2025) conducted an observational in Physical inactivity (n=40,706). Exercise Vital Sign (EVS) screening vs. No screening / Inactive or insufficiently active patients was evaluated on Rates of comorbid conditions (e.g., obesity, diabetes, hypertension) (p=<.001). Active patients identified via the Exercise Vital Sign had a significantly lower risk of 19 inactivity-related comorbid conditions, including obesity, diabetes, and hypertension (all P < .001).
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