Effectiveness of Social Prescribing Programs in the Primary Health-Care Context: A Systematic Literature Review

Abstract

Social prescribing (SP) is an approach that promotes the use of local non-clinical activities by people. The referral is usually made by primary health-care professionals, in a process wherein local providers play a pivotal role. The main objective of this study was to identify domains of intervention and evidence about the effectiveness of SP programs regarding health-related outcomes. A systematic literature review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was conducted in PubMed, CINHAL, and SCOPUS. Inclusion criteria of the reviewed papers were as follows: (i) effectiveness studies of interventions designated as SP or interventions entailing SP conceptual components; (ii) interventions with adults. Quality assessment was performed with the Cochrane tool for assessing risk of bias in randomized trials; an assessment tool developed by the US National Heart, Lung and Blood Institute was applied to observational studies. Overall, 13 articles were included for analysis, with a total of 4603 patients. Although three studies comprised a control group, only two followed a randomized controlled trials (RCT) design. Nine principal domains of intervention within SP were identified, with three categories of outcome measures: Physical and psychological wellbeing; Health behaviors and self-efficacy; and Health care resources end economic evaluation. SP is an emergent and promising health-care intervention, and it has been used to promote different health behaviors. Evidence of SP effectiveness on patient’s health and wellbeing is not strong. Further research is needed for understanding how SP can be applied efficiently.

Developing a social prescribing local system in a European Mediterranean country: a feasibility study to promote active and healthy aging

“…Regarding the profile of patients considered to be more likely to adhere to SP successfully, the majority (83,9%) of HP considered that being a woman would be the most prevalent characteristic in facilitating adherence, which is in line with the literature [ 15 ]. This may be related to the perception of HP about the difficulty of men in seeking help about their emotional needs and help support compliance [ 34 ].…”

“…Despite being an emerging approach, SP has been already successfully implemented by several professionals and communities. However, so far, there is a lack of consistent evidence about its effectiveness [ 3 , 5 , 14 ], partly due to diverse study designs and the shortage of studies with proper assessments [ 15 ]. Additionally, few published studies show the use of SP in populations culturally different from the United Kingdom, where SP is widely used, which hinders the assessment of how SP can play a role in different health care national services.…”

Challenges and Approaches to Green Social Prescribing During and in the Aftermath of COVID-19: A Qualitative Study

“…The NHS webpage on green social prescribing stresses the importance of being outdoors for people’s mental and physical health, and for equality of access to green spaces ( NHS England, 2022b ). Yet, the creation of healthy environments is complex, with population health closely related to socioeconomic conditions ( Costa et al, 2021 ). Also, for much of the past 2 years, people have been urged to stay indoors or stay local as much as possible.…”

“…Arguments in favor of social prescribing as a valuable non-medical form of health care seem compelling ( Islam, 2020 ), however, the systematic evidence concerning effectiveness of social prescribing on reducing GP visits and increasing patient health and wellbeing is not strong ( Bickerdike et al, 2017 ; Gibson et al, 2021 ). Comparisons between social prescribing schemes are problematic as they adopt different models of healthcare ( Fixsen et al, 2020 ) and are situated in areas of greater or lesser socioeconomic need ( Costa et al, 2021 ). Critics of social prescribing point to a reliance on community goodwill and use of individual-level health interventions to address socially and economically embedded issues, which demand the implementation of government-level interventions ( Bickerdike et al, 2017 ; Mackenzie et al, 2020 ; Gibson et al, 2021 ).…”

A Systematic Review to Examine the Evidence in Developing Social Prescribing Interventions That Apply a Co-Productive, Co-Designed Approach to Improve Well-Being Outcomes in a Community Setting

“…Previous reviews conclude by pointing to the need for a common SP evaluation framework to overcome such difficulties and facilitate the cross-site comparison of interventions and sharing of results [4,10,11]. Existing evidence indicates that SP is a developing concept and there is a variation in approaches to SP referrals and modes of delivery [4], along with SP providers and end-users [12] This variation further hinders drawing together key findings on SP interventions, in addition to studies not being published and activities not being labelled as SP interventions [13].…”