Social Prescribing: Systematic Review of the Effectiveness of Psychosocial Community Referral Interventions in Primary Care

Abstract

Introduction: Social prescribing (SP) aims to provide targeted psychosocial support and close the gap between medical and non-medical services. This review assesses the effectiveness of community-based SP interventions. Methods:We performed a systematic review and qualitative synthesis of interventional studies of community referral interventions focused on facilitating psychosocial support. We considered health-related endpoints, other patient reported outcomes, or health care utilization. Six databases, grey literature, and additional trials registers were searched. Results were screened in a two-step process, followed by data extraction, each by two independent reviewers. If data permitted such, effect sizes were calculated. Risk of bias was assessed with the EPHPP and the Cochrane RoB2 tools. Results:We identified 68 reports from 53 different projects, three were controlled studies. Uncontrolled studies with shorter time frames frequently reported positive effects. This could largely not be seen in controlled settings and for longer follow-up periods. Designs, populations, and outcomes evaluated were heterogeneous with high risk of bias for most studies.Discussion and conclusion: Current evidence suggests positive effects of SP on a variety of relevant endpoints. Due to quality deficits in the available studies, scope for conclusions concerning clinical relevance and sustainability is limited. Further methodologically rigorous controlled trials are needed. ZUSAMMENFASSUNGEinleitung: Social prescribing (SP) soll gezielte psychosoziale Unterstützung ermöglichen und die Lücke zwischen medizinischen und nicht-medizinischen Angeboten schließen. Diese Übersichtsarbeit untersucht die Wirksamkeit von gemeindebasierten SP-Interventionen.

Effectiveness of social prescribing for chronic disease prevention in adults: a systematic review and meta-analysis of randomised controlled trials

“…Our study resonates with preceding SP reviews regarding the limitations in the available evidence and the need for further high-quality research 23 24 26 29 34 76–78. As we envisioned, there is limited development and evaluation of SP interventions to address the chronic disease risk factors in adults.…”

“…Findings from the present review and numerous SP reviews of other health outcomes23 24 26 27 29 30 33 35 36 76 81 have clearly shown that the evidence was still insufficient and scientifically inconclusive to justify the recommendation reliably. Some immediate increases in physical activity and energy expenditure are noted in our study, but whether the benefits sustain post-trial is questionable.…”

“…When this review was recently updated by Griffiths et al 24 to include the new evidence until July 2021, the limitations persisted. Similarly, many other reviews increasingly emphasised methodological deficits in the available studies that might undermine the efforts in judging clinical effectiveness 26 29–31 33 36 76–78. Most biases in our eligible studies stemmed from outcome assessment, missing data and poor reporting.…”

Can social prescribing put the ‘social’ into the biopsychosocial management of people with long‐term musculoskeletal disorders?

“…Research on the effectiveness of SP is emerging and remains equivocal (Bickerdike et al, 2017;Kimberlee, 2015;Napierala et al, 2022;O'Sullivan et al, 2022). Existing studies evaluating SP interventions have been criticized for their methodological limitations (Kiely et al, 2021;Kimberlee, 2015).…”

The feasibility of identifying health inequalities in social prescribing referrals and declines using primary care patient records

“…Whilst there is considerable evidence to support the use of SP 4,5 , a common criticism is a lack of robust evidence on its effectiveness [6][7][8][9][10] . SP has been suggested as a tool to reduce health inequalities by supporting individuals in areas of deprivation [11][12][13][14] .…”