Yadav Uday Narayan, Paudel Grish, Ghimire Saruna, Khatiwada Bhushan, Gurung Ashmita, Parsekar Shradha S, Mistry Sabuj Kanti
National Centre for Aboriginal and Torres Strait Islander Well-Being Research, The Australian National University, Canberra, ACT, Australia.
Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
BMC Public Health. 2024 Jan 27;24(1):306. doi: 10.1186/s12889-024-17736-2.
People with long-term chronic conditions often struggle to access and navigate complex health and social services. Social prescription (SP) interventions, a patient-centred approach, help individuals identify their holistic needs and increase access to non-clinical resources, thus leading to improved health and well-being. This review explores existing SP interventions for people with long-term chronic conditions and identifies the opportunities and challenges of implementing them in primary healthcare settings.
This rapid review followed the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines and searched relevant articles in three databases (PubMed/MEDLINE, EMBASE, and Web of Science) by using subject headings and keywords combined with Boolean operators. The search encompassed articles published between January 2010 and June 2023. Two authors independently conducted study screening and data abstraction using predefined criteria. A descriptive synthesis process using content analysis was performed to summarise the literature.
Fifteen studies were included, with all but one conducted in the United Kingdom, and revealed that social prescribers help guide patients with long-term chronic conditions to various local initiatives related to health and social needs. Effective implementation of SP interventions relies on building strong relationships between social prescribers and patients, characterised by trust, empathy, and effective communication. A holistic approach to addressing the unmet needs of people with long-term chronic conditions, digital technology utilisation, competent social prescribers, collaborative healthcare partnerships, clinical leadership, and access to local resources are all vital components of successful SP intervention. However, the implementation of SP interventions faces numerous challenges, including accessibility and utilisation barriers, communication gaps, staffing issues, an unsupportive work environment, inadequate training, lack of awareness, time management struggles, coordination and collaboration difficulties, and resource constraints.
The present review emphasises the importance of addressing the holistic needs of people with long-term chronic conditions through collaboration and coordination, training of social prescribers, community connections, availability of local resources, and primary care leadership to ensure successful interventions, ultimately leading to improved patient health and well-being outcomes. This study calls for the need to develop or utilise appropriate tools that can capture people's holistic needs, as well as an implementation framework to guide future contextual SP interventions.
患有长期慢性病的人在获取和应对复杂的健康及社会服务方面往往面临困难。社会处方（SP）干预作为一种以患者为中心的方法，有助于个人识别其整体需求并增加获得非临床资源的机会，从而改善健康状况和幸福感。本综述探讨了针对长期慢性病患者的现有SP干预措施，并确定了在初级医疗保健环境中实施这些措施的机遇和挑战。
本快速综述遵循系统评价和荟萃分析的首选报告项目指南，通过使用主题词和关键词结合布尔运算符在三个数据库（PubMed/MEDLINE、EMBASE和Web of Science）中检索相关文章。检索范围涵盖2010年1月至2023年6月发表的文章。两位作者使用预定义标准独立进行研究筛选和数据提取。采用内容分析的描述性综合过程对文献进行总结。
纳入了15项研究，除一项外均在英国进行，结果显示社会处方师帮助指导患有长期慢性病的患者参与各种与健康和社会需求相关的当地倡议。有效实施SP干预措施依赖于在社会处方师和患者之间建立牢固的关系，其特点是信任、同理心和有效的沟通。采用整体方法满足长期慢性病患者未得到满足的需求、利用数字技术、有能力的社会处方师、协作性的医疗保健伙伴关系、临床领导力以及获取当地资源，都是成功实施SP干预的重要组成部分。然而，实施SP干预面临众多挑战，包括可及性和利用障碍、沟通差距问题、人员配备问题、不利的工作环境、培训不足、缺乏认识、时间管理困难、协调与协作困难以及资源限制。
本综述强调了通过协作与协调、对社会处方师的培训、社区联系、当地资源的可用性以及初级保健领导力来满足长期慢性病患者的整体需求的重要性，以确保干预措施取得成功，最终改善患者的健康状况和幸福感。本研究呼吁需要开发或利用能够捕捉人们整体需求的适当工具，以及一个实施框架来指导未来因地制宜的SP干预。
