Social prescribing and supported self-management: A scoping review of the potential for implementation in non-surgical oncology services.

Background

Social prescribing and supported self-management are two components of the National Health Service (NHS) personalised care model and have proven effectiveness in primary care settings. Social prescribing is a range of non-clinical services that address the psychological, psychosocial, and environmental issues affecting a person's well-being. Patients undertake supported self-management tasks to increase their knowledge, skills, and confidence in managing their health and medical care. However, these practices are not yet routinely integrated into radiation therapy. With 53.5 million people alive with cancer within 5 years of diagnosis worldwide, potentially living with the long-term effects of cancer and its treatments, there is significant potential for the application of social prescribing and supported self-management within radiation therapy, specifically, with application globally.

Methods

A scoping review was conducted utilising PubMed, ScienceDirect, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) Ultimate online electronic databases. The Joanna Briggs Institute critical appraisal checklists were employed as appraisal tools, and the review adhered to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

Results

From five different countries, twelve studies met the inclusion criteria. The Joanna Briggs Institute critical appraisal grid identified three predominant themes: the needs and current clinical practices of healthcare professionals; the unmet needs experienced by patients; and existing strategies in practice and future directions. Breast cancer was the largest cancer diagnosis represented across the included studies, while this provides insight into patients' experiences, the unmet needs of other cancer diagnoses may differ and are not fully explored in this review.

Discussion

Various non-surgical oncology-based (encompassing all oncology treatments, excluding surgery), social prescribing and supported self-management strategies were identified, providing continuous support to patients from diagnosis to 'living with and beyond cancer'. Non-surgical oncology health care professionals (particularly radiation therapists) are well placed to recommend social prescribing and supported self-management. However, additional training is required to improve knowledge and confidence in doing so. A hybrid approach offering both online and in-person support was deemed effective, enhancing the accessibility of course content and enabling patient participation at their convenience. While these programs are well-established in the community, hospitals must strengthen their connections with primary care networks to bridge the gap between treatment completion and the support needed during 'living with and beyond cancer'.

Conclusion

This review identifies the need to prioritise further support for the individual needs of non-surgical oncology patients throughout their care pathway. The benefits of early implementation of social prescribing and supported self-management strategies are evident, suggesting that these interventions should not be delayed until treatment is complete.

Plain language summary

People living with cancer often need support beyond medical treatment to manage their health and wellbeing. This study reviewed research on social prescribing, which links people to non-medical support and self-management in cancer care, focusing on their use in radiation therapy. This study found that these approaches can help meet patient needs across the care journey, but they are not widely used in radiotherapy and staff may need more training to deliver them. This matters because offering this support earlier and more consistently could improve quality of life for people living with and beyond cancer.