Carnes Dawn, Sohanpal Ratna, Frostick Caroline, Hull Sally, Mathur Rohini, Netuveli Gopalakrishnan, Tong Jin, Hutt Patrick, Bertotti Marcello
Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Centre for Primary Care and Public Health, 58 Turner St, London, E1 2AB, UK.
University of Applied Sciences Western Switzerland, School of Health Sciences, Route des Cliniques 15, 1700, Fribourg, Switzerland.
BMC Health Serv Res. 2017 Dec 19;17(1):835. doi: 10.1186/s12913-017-2778-y.
Social prescribing is targeted at isolated and lonely patients. Practitioners and patients jointly develop bespoke well-being plans to promote social integration and or social reactivation. Our aim was to investigate: whether a social prescribing service could be implemented in a general practice (GP) setting and to evaluate its effect on well-being and primary care resource use.
We used a mixed method evaluation approach using patient surveys with matched control groups and a qualitative interview study. The study was conducted in a mixed socio-economic, multi-ethnic, inner city London borough with socially isolated patients who frequently visited their GP. The intervention was implemented by 'social prescribing coordinators'. Outcomes of interest were psychological and social well-being and health care resource use.
At 8 months follow-up there were no differences between patients referred to social prescribing and the controls for general health, depression, anxiety and 'positive and active engagement in life'. Social prescribing patients had high GP consultation rates, which fell in the year following referral. The qualitative study indicated that most patients had a positive experience with social prescribing but the service was not utilised to its full extent.
Changes in general health and well-being following referral were very limited and comprehensive implementation was difficult to optimise. Although GP consultation rates fell, these may have reflected regression to the mean rather than changes related to the intervention. Whether social prescribing can contribute to the health of a nation for social and psychological wellbeing is still to be determined.
社会处方针对的是孤立和孤独的患者。从业者和患者共同制定定制的幸福计划,以促进社会融合和/或社会重新融入。我们的目的是调查:社会处方服务是否可以在全科医疗(GP)环境中实施,并评估其对幸福感和初级保健资源使用的影响。
我们采用了一种混合方法评估方法,包括对患者进行调查并设置匹配的对照组,以及进行定性访谈研究。该研究在伦敦市中心一个社会经济混合、多民族的行政区进行,研究对象是经常就诊的全科医生且社会孤立的患者。干预措施由“社会处方协调员”实施。感兴趣的结果是心理和社会幸福感以及医疗保健资源的使用。
在8个月的随访中,接受社会处方转诊的患者与对照组在总体健康、抑郁、焦虑以及“积极主动地参与生活”方面没有差异。接受社会处方转诊的患者看全科医生的频率较高,在转诊后的一年内有所下降。定性研究表明,大多数患者对社会处方有积极的体验,但该服务未得到充分利用。
转诊后总体健康和幸福感的变化非常有限,全面实施难以优化。虽然看全科医生的频率下降了,但这可能反映的是均值回归,而非与干预相关的变化。社会处方是否能为国家的社会和心理健康做出贡献仍有待确定。