The medicalisation of disease means that lots of time and money is spent on researching the effectiveness of pharmaceutical options, but very little attention is directed at researching non medical interventions such as exercise and healthy eating.

When LSE’s Huseyin Naci and his colleague, Professor John Ioannidis from the Stanford University School of Medicine, were comparing the mortality benefits associated with drug and exercise interventions in coronary heart disease, stroke, heart failure and pre-diabetes, they found that exercise appears to be as effective as phamacalogical interventions.

However, before we stop taking our pills, emptying our medicine cabinets, and hitting the gym  –  they advise us to look at their study more closely.

“Our study is not without limitations”, writes Huseyin Naci in the LSE Health and Social Care blog. “Most importantly, there is a significant asymmetry in the existing body of scientific evidence on the mortality benefits of drug and exercise interventions for common diseases, demonstrating the paucity of data on the effectiveness of exercise interventions in scientific studies. It is possible that such an asymmetry influenced our findings…Our findings reflect the bias against testing exercise interventions and highlight the changing landscape of medical research, which appears to increasingly favour pharmaceutical interventions over lifestyle modification strategies”.

Naci and Ionnaides suggest that we have medicalised common conditions, and the current medical literature points clinicians in the direction of pharmaceutical options.  “The current state of medical research gives the false impression to patients, clinicians, and other decision makers that pharmacological interventions are superior to non-pharmacological alternatives, and hence hinders evidence-based decision-making in clinical practice”.

So it looks as if exercise is as good or better than pills for some conditions, and there is certainly a lot of anecdotal evidence to suggest that is the case, but there will need to be a lot more research before we can say for sure.

For the full article, see Naci H, Ioannidis JPA (2013) Comparative effectiveness of exercise and drug interventions on mortality outcomes: A meta-epidemiological study, British Medical Journal, 347, f5577.

References

Naci H, Cylus J, Vandoros S, Sato A, Perampaladas K (2012) Raising the bar for market authorisation of new drugs, British Medical Journal, 345, e4261.

Sorenson C, Naci H, Cylus J, Mossialos E (2011) Evidence of comparative efficacy should have a formal role in European drug approvals, British Medical Journal, 343, d4849.

Huseyin Naci is a doctoral candidate in Pharmaceutical Policy and Economics within LSE Health, and Thomas O. Pyle Fellow in Population Medicine at Harvard University. h.naci@lse.ac.uk

Tags: Exercise, Health, Heart Disease, Pharmaceuticals