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Abstract
Background Social prescribing (SP) enables healthcare professionals to link patients with non-medical interventions available in the community to address underlying socioeconomic and behavioural determinants. We synthesised the evidence to understand the effectiveness of SP for chronic disease prevention.
Methods A systematic literature search was conducted using five databases and two registries. Eligible studies included randomised controlled trials of SP among community-dwelling adults recruited from primary care or community setting, investigating any chronic disease risk factors defined by the WHO (behavioural factors: smoking, physical inactivity, unhealthy diet and excessive alcohol consumption; metabolic factors: raised blood pressure, overweight/obesity, hyperlipidaemia and hyperglycaemia). Random effect meta-analyses were performed at two time points: completion of intervention and follow-up after trial.
Results We identified nine reports from eight trials totalling 4621 participants. All studies evaluated SP exercise interventions which were highly heterogeneous regarding the content, duration, frequency and length of follow-up. Majority of studies had some concerns for risk of bias. Meta-analysis revealed that SP likely increased physical activity (completion: mean difference (MD) 21 min/week, 95% CI 3 to 39, I2=0%; follow-up ≤12 months: MD 19 min/week, 95% CI 8 to 29, I2=0%). However, SP may not improve markers of adiposity, blood pressure, glucose and serum lipid. There were no eligible studies that primarily target unhealthy diet, smoking and excessive alcohol drinking behaviours.
Conclusions SP exercise interventions probably increased physical activity slightly; however, no benefits were observed for metabolic factors. Determining whether SP is effective in modifying the determinants of chronic diseases and promotes sustainable healthy behaviours is limited by the current evidence of quantification and uncertainty, warranting further rigorous studies.
PROSPERO registration number CRD42022346687.
- LIFE STYLE
- META-ANALYSIS
- PRIMARY HEALTH CARE
- SYSTEMATIC REVIEW
- HEALTH PROMOTION
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
Footnotes
Twitter @danny_hlh, @AchamTeshale, @mirandacumpston, @DrJoRyan, @DrFreakPoli
Contributors HLH: identification and screening of records, data extraction, risk of bias assessment, formal analysis, investigation, validation, visualisation, data interpretation, writing—original draft, writing—review & editing, guarantor. ABT: screening of records, data extraction, risk of bias assessment, validation, writing—review & editing. MSC: investigation, data interpretation, validation, writing—review & editing. LD: writing—review & editing. JR: writing—review & editing. AO: supervision, writing—review & editing. RF-P: conceptualisation, supervision, data interpretation, writing—review & editing. All authors approved the final version for submission.
Funding HLH and ABT are supported by Monash International Tuition Scholarship and Monash Graduate Scholarship. None of the funders were involved in the design of the study, collection, analysis, and interpretation of data and writing of the manuscript.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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