Do GP's practices which employ Social Prescribing exhibit similar patterns in the prescription of pain and antidepressant medication?

Problem

One of the goals of the NHS 'Long Term Plan', is to greatly increase the access to social prescribing schemes through 'link workers' working within GP's practices. It is hoped that through the increased uptake of such programmes problems such as over-medication can be addressed. To date, the trends of prescription rates for pain and anti-depressant medications, within practices employing social prescribing, have not been compared and contrasted. This study aims to inform further research into the role of social prescribing in the treatment of chronic musculoskeletal conditions.

Approach

This study took three NHS locations with award-winning social prescribing programmes and compared their opioid, non-opioid, anti-inflammatory, and anti-depressant medication rates, both with each other and the NHS means over a five-year period. These medications were selected as they are relatively common and they can possibly be seen as surrogate indicators for chronic musculoskeletal health conditions. The prescription data was taken from the University of Oxford's DataLab, and the practice patient numbers from NHS Digital. Linear regression analyses were performed for each medication type, at each of the three locations and the NHS England mean figures for the same period.

Findings

In all but one medication type, in one location, the prescription rates of opioid, non-opioid, anti-depressant, and anti-inflammatory medication decreased over the study period in comparison with NHS means. However, the actual prescription rates varied considerably between locations with, as an example, prescription rates of opioids and anti-depressants being over twice as great within a Somerset market town, compared to those from a deprived inner-city CCG.

Consequences

Although the three study groups showed a greater decrease in prescription rates, in almost every case, compared to NHS means, it cannot be ascertained whether the improvements are representative of improvements from patients actually involved in social prescribing schemes. It could be that these improvements are due to a general change in culture within these health locations. However, from these findings, it would appear important to consider also the clinical and financial change which could be achieved if the individual, health culture or community factors behind the disparity in prescription rates could be identified and changes made accordingly.