Social prescribing to improve health and well-being of patients presenting with non-medical health related social needs in primary care: a multi-center randomized controlled pragmatic feasibility trial

• Applicant: Professor Dr. Wolfram Joachim Herrmann
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine
• Term: since 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 530364906

Non-medical health related social problems are highly prevalent in primary care. They can have a considerable impact on the development and course of mental and physical health. Such social problems can, however, also be caused by (chronic) disease. They are associated with considerable economic costs, such as sick leave and long-term absence from work. Social Prescribing (SP) is a potential solution: SP was developed in the UK and has become widely established in the NHS in recent years. Globally, social prescribing schemes have been implemented in several countries, such as Singapore and Canada. SP equips General Practitioners (GPs) with a non-medical referral option, which can accompany existing treatments to improve health and well-being. SP is implemented by involving a “link worker” to whom patients with non-medical health-related social needs are referred to (= issued a “social prescription”). In a first step, the link worker assesses needs, agrees on a goal and develops an action plan together with the patient. The action plans includes referrals to existing non-clinical support and services in the community. The link worker supports the patient to access these services. At the end of the intervention, the link worker gives feedback to the prescribing GP. The contact between link worker and patient usually involves several consultations over the course of several weeks. Although numerous projects evaluating SP in other healthcare settings have been conducted, no RCTs on SP have been performed in Germany. Thus, the goal of this trial is to test the feasibility of a randomized controlled trial (RCT) on SP in the primary care setting in Germany. The trial is designed as an exploratory, multi-center, two-armed, open, randomized controlled, pragmatic, feasibility trial. SP is compared with treatment-as-usual plus a brochure with information about local offers for non-clinical support and services in the community. We will recruit about 300 participants (2:1 randomization into SP vs. control) in seven participating GP practices (study centers). The primary endpoint is the feasibility measured by (1) proportion of participants who have at least one appointment with the link worker (intervention arm only), (2) proportion of participants that drop out of the trial before the 6-month follow-up (, both arms). Secondary endpoints include acceptability, practicality, and demand/utilization, as well as clinical endpoints for health status, well-being, and community connection. The results of this feasibility trial will inform the design of a confirmatory randomized controlled trial providing evidence on the effect of social prescribing in Germany.

• DFG Programme: Clinical Trials
• Co-Investigator: Dr. Hendrik Napierala