Tensions and opportunities in social prescribing. Developing a framework to facilitate its implementation and evaluation in primary care: a realist review

Calderón-Larrañaga, S; Milner, Y; Clinch, M; Greenhalgh, T; Finer, S

Journal article

Tensions and opportunities in social prescribing. Developing a framework to facilitate its implementation and evaluation in primary care: a realist review

Abstract:: Background Frailty increases vulnerability to major health changes because of seemingly small health problems. It affects around 10% of people aged >65 years. Older adults with frailty frequently have multiple long-term conditions, personal challenges, and social problems. Personalised care planning (PCP) based on ‘goal setting’ and ‘action planning’ is a promising way to address the needs of older adults living with frailty. Aim To identify and explore factors that influence the implementation of PCP-style interventions for older adults. Design & setting We conducted a scoping review and identified a small number of interventions that explicitly employed goal setting and action planning. Method We used a range of sources to identify relevant material. We included all interventions inclusive of patients aged ≥65 years and reported in English. We excluded end-of-life care interventions, group education, and/or those that did not involve one-to-one engagement. We explored all related articles that described, examined, or discussed implementation. We constructed a thematic framework in NVivo (version 11). Findings were narratively synthesised. Results We identified 18 potentially relevant PCP-style interventions and 13 of these met the inclusion criteria. Within these, were seven main categories of potentially modifiable influences relevant to older adults with frailty related to the following: primary care engagement; delivery staff characteristics; training; patient engagement; collaborative working; organisation and management; and systems. Conclusion Many modifiable factors can influence the implementation of PCP. We identified several influences that have informed the development and implementation of a novel intervention PeRsOnaliSed care Planning for oldER people with frailty (PROSPER)

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Calderón-Larrañaga, S., Milner, Y., Clinch, M., Greenhalgh, T., & Finer, S. (2021). Tensions and opportunities in social prescribing. Developing a framework to facilitate its implementation and evaluation in primary care: a realist review. British Journal of General Practice Open, 5(3), BJGPO.2021.0017-BJGPO.2021.0017.

MLA Style

Calderón-Larrañaga, S, et al. “Tensions and Opportunities in Social Prescribing. Developing a Framework to Facilitate Its Implementation and Evaluation in Primary Care: a Realist Review.” British Journal of General Practice Open, vol. 5, no. 3, 2021, pp. BJGPO.2021.0017-BJGPO.2021.0017.

Chicago Style

Calderón-Larrañaga, S, Y Milner, M Clinch, T Greenhalgh, and S Finer. 2021. “Tensions and Opportunities in Social Prescribing. Developing a Framework to Facilitate Its Implementation and Evaluation in Primary Care: a Realist Review.” British Journal of General Practice Open 5 (3): BJGPO.2021.0017-BJGPO.2021.0017.
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