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What to do when the best intervention for a patient is not a medical one?

Posted on July 13, 2020

A New England Journal of Medicine article discusses ‘social prescribing’—an initiative to refer patients to socially or community-oriented interventions in an effort to reduce health care costs and utilization when lifestyle changes may alleviate the problem.

In the Perspectives article, Roland M et al argue that social interventions have the potential to reduce disparities sometimes seen in health, especially among disadvantaged communities where medical issues are often made worse by social issues. In addition, it may help lessen unnecessary tests, procedures, and prescriptions.

“Some of these interventions have a clear biomedical intent — for example, exercise and weight reduction programs to reduce dependence on medication among people with diabetes,” wrote the authors. “But social prescribing has a wider purpose. It’s also about culture change — challenging the propensity to medicalize health and professionalize health care. And it’s about changing the expectations of patients (and their physicians) that a drug will solve their problems by empowering patients to invest in their own health.

Despite the potential for good, very few studies have been done to determine the actual benefits of social prescribing. The authors hope the United Kingdom’s National Health Service, which is currently implementing a large-scale social prescribing program, will provide research on which groups are most likely to benefit from social interventions.  

Reference

Roland M, Everington S, Marshall M. Social prescribing — transforming the relationship between physicians and their patients. N Engl J Med. 2020; 383:97-99
DOI: 10.1056/NEJMp1917060

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