Background: Insufficient physical activity (PA) is a risk factor for developing cardiovascular disease (CVD), cancer and diabetes. To increase the physical activity level among the population a health promotion approach is needed. Physical activity on prescription (PAP) is a treatment method designed to support patients to increase their PA level, it is based on a structured planning, follow-up and evaluation of PA. The Swedish PAP-treatment has now been used in the last decade for increased physical activity and there is no evidence of how the treatment method works over a long period of time.

Methods: The aim of this observation study was to describe changes in PA level and health related quality of life (HRQOL) during 18 months follow-up of PAP-treatment in primary health care. This study includes 346 patients from 15 primary health centers in Gothenburg, age 27-85, who had at least one component of Metabolic Syndrome (MetS) and were physically inactive. The PAP-treatment included individualized dialogs between the patient and the nurse, a PAP and a structured follow-up. 214 patients (61.8%) completed the 18-month follow-up. Results: There was a significant improvement (p = <0.001) in physical activity level and 59.1% increased their PA to a sufficient PA level, according to public health recommendations. There were also some significant improvements in health-related quality of life in: general health, vitality, social function, mental health and mental component summery, assessed by the Short Form 36.

Conclusions: This study indicates that PAP-treatment has a potential of improving peoples PA level and mental health quality of life.