Hamilton-West Kate, Milne Alisoun, Hotham Sarah
Centre for Health Services Studies, University of Kent.
School of Social Policy, Sociology and Social Research, University of Kent.
Age Ageing. 2020 Apr 27;49(3):319-326. doi: 10.1093/ageing/afaa016.
Older people's health and care needs are changing. Increasing numbers live with the combined effects of age-related chronic illness or disability, social isolation and/or poor mental health. Social prescribing has potential to benefit older people by helping those with social, emotional or practical needs to access relevant services and resources within the local community. However, researchers have highlighted limitations with the existing evidence-base, while clinicians express concerns about the quality of onward referral services, liability and upfront investment required. The current article provides a critical review of evidence on social prescribing, drawing on the RE-AIM Framework (Glasgow et al., 1999) to identify questions that will need to be addressed in order to inform both the design and delivery of services and the evolving research agenda around social prescribing. We emphasise the need for researchers and planners to work together to develop a more robust evidence-base, advancing understanding of the impacts of social prescribing (on individuals, services and communities), factors associated with variation in outcomes and strategies needed to implement effective and sustainable programmes. We also call on policymakers to recognise the need for investment in allied initiatives to address barriers to engagement in social prescribing programmes, provide targeted support for carers and improve access to older adult mental health services. We conclude that social prescribing has potential to support older people's health and wellbeing, but this potential will only be realised through strategic alignment of research, local level implementation and national policy and investment.
老年人的健康和护理需求正在发生变化。越来越多的老年人同时受到与年龄相关的慢性病或残疾、社会孤立和/或心理健康不佳的综合影响。社会处方有潜力使老年人受益，它能帮助那些有社会、情感或实际需求的人在当地社区获得相关服务和资源。然而，研究人员强调了现有证据基础的局限性，而临床医生则对后续转诊服务的质量、责任和所需的前期投资表示担忧。本文对社会处方的证据进行了批判性综述，借鉴了RE-AIM框架（格拉斯哥等人，1999年）来确定为服务的设计与提供以及围绕社会处方的不断发展的研究议程提供信息所需解决的问题。我们强调研究人员和规划者需要共同努力，建立更强大的证据基础，增进对社会处方（对个人、服务和社区）影响的理解，了解与结果差异相关的因素以及实施有效和可持续项目所需的策略。我们还呼吁政策制定者认识到需要对相关举措进行投资，以消除参与社会处方项目的障碍，为护理人员提供有针对性的支持，并改善老年人心理健康服务的可及性。我们的结论是，社会处方有潜力支持老年人的健康和福祉，但只有通过研究、地方层面的实施以及国家政策和投资的战略协调，这一潜力才能实现。
