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Primary care providers exploring value of “social prescriptions” for patients

Caroline Mercer | Toronto, Ont. | November 22, 2018

Doctors in Montreal can write prescriptions for free museum visits.

Physicians in Montreal can now prescribe a trip to the museum for patients who might benefit from a day spent admiring fine art.

“We strongly believe that this exposure to art will help alleviate symptoms and anxiety,” said Nicole Parent, director general of Médecins francophones du Canada. The association launched the pilot project in partnership with the Montreal Museum of Fine Arts.

The experiment is part of a growing movement toward “social prescriptions,” which allow primary care providers to target the social needs of patients through non-drug interventions. Last year, the United Kingdom popularized the idea as part of a national strategy against loneliness.

Physicians can prescribe free museum admission for a patient and three family members. According to Parent, patients with either mental or physical health problems can benefit from the program. For example, studies have shown that art therapy can improve emotional well-being and attention in patients with Alzheimer disease. For patients with chronic diseases or cancer, a visit to the museum can be an opportunity to spend quality time with relatives and “forget for a moment all the sadness and all the anxiety related to a diagnosis,” said Parent.

Nathalie Bondil, director general and chief curator of the Montreal Museum of Fine Arts, proposed the idea to the physician organization at its annual meeting. Bondil has made health a priority at the museum, which is home to the largest education and art therapy centre of its kind in North America. Eighteen research projects have been conducted at the museum, measuring the health impact of art on patients with Alzheimer disease, eating disorders, breast cancer and other medical conditions.

Andrew Wister, director of a gerontology research centre at Simon Fraser University, said social prescriptions can help address a growing epidemic of loneliness in Canada. According to Wister, data suggest about 1 in 4 Canadians experience some degree of loneliness. People who identify as LGBTQ, have a mental illness, live in remote areas or are older are especially vulnerable. Research has also connected loneliness to higher mortality rates, prompting some to compare it to smoking a pack of cigarettes a day.

Loneliness in modern society may be increasing, said Wister, because of social change and greater reliance on technology. The issue is also gaining more public attention. The UK, for example, started a national conversation when they appointed a minister of loneliness in early 2018.

Social prescriptions are coming to Ontario, too. The Alliance for Healthier Communities has received funding from the province’s health ministry to implement a 1-year pilot project inspired by the UK model. Kate Mulligan, director of policy and communications for the alliance, said that loneliness and social isolation are key issues the program aims to address. Prescriptions will be tailored to meet the specific needs of patients and communities and could include anything from cooking classes to advocacy groups. Support could also go toward practical needs, such as helping patients complete their taxes.

“Really, the sky’s the limit,” said Mulligan.

Staff, volunteers and clients at the Centretown Community Health Centre in Ottawa, 1 of 11 participating centres, are brainstorming ideas. According to Natasha Beaudin, a health promoter with the centre, the running list includes a film club and makeup classes for people transitioning from male to female.

According to Mulligan, framing social recommendations as prescriptions will make it easier for clinicians to connect patients to potentially helpful programs. “We’re using their language,” Mulligan said. It may also lead to patients taking the recommendations more seriously. A New Zealand study found that written prescriptions for physical activity were better at getting patients to exercise than verbal advice alone, suggesting that prescriptions may carry some psychological weight.

Médecins francophones du Canada will be evaluating the success of its pilot through a study. For Parent, early reception of the idea suggests that physicians are becoming increasingly interested in non-drug interventions. “Their reaction is great enthusiasm,” Parent said. “They are more and more open to all of this.”

Photo credit: NicholasMcComber/iStock

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