14 Improving documentation of physical activity advice for patients with depression and anxiety newly started on antidepressants in primary care: a quality improvement project

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Background Physical activity is a core pillar of lifestyle medicine and an evidence-based intervention for depression. In routine primary care, however, physical-activity advice may be discussed but not consistently documented, reducing its visibility within holistic care and limiting continuity and auditability. This project aimed to improve documentation of physical-activity advice for patients with common mental health conditions newly started on antidepressants.Methods A closed-loop quality improvement project was conducted in a UK NHS general practice. Adult patients newly started on antidepressants were identified using a pragmatic SystemOne search. Baseline data were collected for September 2025 and re-audit data for November 2025. Primary analysis focused on patients with a documented mental-health indication: depression, anxiety, or mixed mood disorder. The intervention included staff education, AccuRx templates and patient resources in digital format.Results At baseline, 35 patients were identified, including 21 with a mental-health indication. Documented physical-activity advice was present in 7/21 patients (33.3%). At re-audit, 23 patients were identified, including 15 with a mental-health indication. Documented physical-activity advice was present in 6/15 patients (40.0%), representing an absolute improvement of 6.7 percentage points. Overall documentation across all antidepressant starts changed from 10/35 (28.6%) to 7/23 (30.4%). Documented use of AccuRx increased from 4/7 to 5/6 among mental-health patients receiving advice.Conclusions A simple, low-cost intervention was associated with a modest improvement in documentation of physical-activity advice in primary care mental-health consultations. Practical prompts and ready-made resources may help embed physical activity more consistently within routine lifestyle medicine delivery and support implementation of non-pharmacological care in everyday practice.

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