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Social prescribing: less rhetoric and more reality.:A systematic review of the evidence

机译:社会处方:较少的修辞和更多的现实。:对证据的系统评价

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摘要

Objectives: Social prescribing is a way of linking patients in primary care with sources of support within the community to help improve their health and well-being. Social prescribing programmes are being widely promoted and adopted in the UK NHS and so we conducted a systematic review to assess the evidence for their effectiveness.Setting/data sources: Nine databases were searched from 2000 to January 2016 for studies conducted in the UK. Relevant reports and guidelines, websites and reference lists of retrieved articles were scanned to identify additional studies. All the searches were restricted to English language only.Participants: Systematic reviews and any published evaluation of programmes where patient referral was made from a primary care setting to a link-worker or facilitator of social prescribing were eligible for inclusion. Risk of bias for included studies was undertaken independently by two reviewers and a narrative synthesis was performed.Primary and secondary outcome measures: Primary outcomes of interest were any measures of health and wellbeing and or utilisation of health services. Results: We included a total of 15 evaluations of social prescribing programmes. Most were small scale and limited by poor design and reporting. All were rated as a having a high risk of bias. Common design issues included a lack of comparative controls, short follow up durations, a lack of standardised and validated measuring tools, missing data and a failure to consider potential confounding factors. Despite clear methodological shortcomings, most evaluations presented positive conclusions. Conclusions: Social prescribing is being widely advocated and implemented but current evidence fails to provide sufficient detail to judge either success or value for money. If social prescribing is to realise its potential, future evaluations must be comparative by design and consider when, by whom, for whom, how well and at what cost.
机译:目标:社会处方是将初级保健患者与社区内支持来源联系起来的一种方式,以帮助改善他们的健康和福祉。社交处方计划在英国NHS中得到广泛推广和采用,因此我们进行了系统的评估以评估其有效性的证据。设置/数据来源:从2000年至2016年1月在英国进行的研究中检索了9个数据库。扫描了相关的报告和指南,网站以及检索到的文章的参考列表,以识别其他研究。所有搜索都仅限于英语。参与者:系统评价和任何已发布的对计划进行评估的计划均符合条件,这些计划包括将患者从基层医疗机构转介到社交处方的链接工作者或协助者。两名研究者独立进行纳入研究的偏倚风险,并进行了叙述性综合。主要和次要结果测量:感兴趣的主要结果是任何有关健康,福祉和/或卫生服务利用的测量。结果:我们总共对社会处方计划进行了15次评估。大多数都是小规模的,并且受到不良设计和报告的限制。所有这些都被认为具有很高的偏见风险。常见的设计问题包括缺乏比较控制,随访时间短,缺乏标准化和经过验证的测量工具,缺少数据以及未能考虑潜在的混杂因素。尽管存在明显的方法学缺陷,但大多数评估仍给出了积极的结论。结论:社会处方被广泛提倡和实施,但是目前的证据未能提供足够的细节来判断成功或物有所值。如果要通过社会处方来发挥其潜力,则未来的评估必须通过设计进行比较,并考虑何时,由谁,为谁,做得如何以及以何种成本进行。

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