Systematic review of the effectiveness of social prescribing for older adults living with frailty or multimorbidity

Introduction

Social prescribing is a widely implemented tool used to support unmet non-medical needs in the community. This systematic review aimed to summarise the impact of social prescribing on a population of older adults living with frailty and/or multimorbidity.

Methods

This review was conducted in line with PRISMA guidelines for systematic review. Searches were completed across MEDLINE, EMBASE and PsychInfo. Social prescribing was defined as co-ordinated multi-component individualised community-based referrals via a link worker. Studies of adults age 65+ or predominantly older adults with a mean age 75+ or people living with frailty and/or multimorbidity were included. The primary outcome of interest was healthcare utilisation (HCU), although a variety of impact metrics were reviewed.

Results

Of the1028 studies meeting initial criteria, eight were included.

Four studies focused on social prescribing as a sole intervention, and four within a multi-disciplinary intervention (MDTI). As a sole intervention, impact on HCU was neutral. Within MDTI there was some evidence of success from non-randomised studies. There was no evidence of cost savings, and only one study measured frailty or polypharmacy. Some positive findings were shown relating to wellbeing and patient activation in small studies, but this was not replicated.

Intervention duration varied from 4 weeks to 6 months and follow up from 4 weeks to 5 years demonstrating major heterogeneity. Risk of bias was high.

Conclusions

There was insufficient high-quality evidence to make clinical recommendations regarding the role of social prescribing for older adults living with frailty and multimorbidity with a notable absence of evidence for people living with dementia or more advanced frailty.