Impact of social prescribing on quality of life and loneliness in geriatric populations: A comprehensive meta-analysis of RCTs with implications for nursing practice

OBJECTIVE: To address the fragmented evidence on the comparative efficacy of social prescribing modalities, this meta-analysis systematically evaluates the differential effects of arts-, physical-, and social-based interventions on quality of life (QoL) and loneliness reduction in older adults. METHODS: Following the PRISMA 2020 guidelines, we systematically searched nine Chinese and international databases (CNKI, VIP, Wanfang, Sinomed, PubMed, etc.) for randomized controlled trials (RCTs) published between 2016 and 2024. Inclusion criteria encompassed community-dwelling adults aged ≥60 years receiving structured social prescribing (arts/physical/social activities) alongside standard care. Methodological rigor was ensured using the Cochrane Risk of Bias 2.0 tool. Anticipating substantial clinical heterogeneity due to cross-cultural variations in intervention delivery, we selected the Random-effects model, supplemented by subgroup analyses to explore intervention type (arts/physical/social), duration (short-term ≤3 months; long-term >3 months), and cultural dimensions. RESULTS: Twenty-six RCTs (n = 3892) were ultimately included. Social prescribing demonstrated significant improvements in QoL and moderate reductions in loneliness. Subgroup analyses indicated that arts-based interventions yielded the largest effect sizes for both QoL and loneliness. The effect of arts-based interventions on loneliness was significantly greater than that of physical- (p < 0.01) and social-based (p < 0.01) approaches, though its larger effect on QoL compared to physical interventions did not reach statistical significance (p = 0.10). CONCLUSION: This meta-analysis delineates critical advancements in geriatric social prescription research, providing evidence that arts-based interventions are a particularly potent option for alleviating loneliness. These findings suggest that nurses should consider incorporating arts-based activities into psychosocial care plans, tailored to individual preferences and cultural contexts. To operationalize these outcomes, future research could explore adaptive intervention frameworks that integrate multidisciplinary resources while addressing heterogeneity in program delivery. Policymakers should support culturally sensitive community programs, recognizing the potential of artistic engagement as a valuable strategy for geriatric mental health.