Background: People with inflammatory arthritis frequently experience loneliness, social isolation, and reduced participation in everyday life, challenges that are rarely addressed in routine rheumatology care [1,2]. These psychosocial difficulties are associated with poorer self-management, higher levels of fatigue, reduced adherence to medication, psychological distress, and increased inflammatory activity and disability [2]. One potential way to address these unmet psychosocial needs is through social prescribing (SP), a model that links clinical care with locally available community resources to support wellbeing, coping, and social connectedness [3]. However, the relevance and feasibility of SP for people with rheumatic diseases, who often experience fluctuating symptoms and require ongoing specialist monitoring, remain unclear. As evidence within rheumatology is limited, this scoping review includes studies across autoimmune conditions that share key features such as chronicity, fluctuating disease activity, and substantial psychosocial burden. This broader scope enables identification of transferable insights that may inform the potential use of SP for people with inflammatory arthritis.

Objectives: To map and synthesize the evidence on factors influencing access, uptake, retention, and effect of social prescribing interventions among adults living with inflammatory arthritis, drawing on studies across autoimmune conditions.

Methods: A scoping review was conducted following Joanna Briggs Institute methodology and PRISMA-Scoping Review guidelines [4,5]. Eligible studies included adults (≥18 years) with autoimmune diseases referred to non-medical, community-based support consistent with social prescribing. Six databases (MEDLINE, Embase, CINAHL, PsycInfo, Scopus, Cochrane Reviews) and grey literature sources were searched without time limits. Studies published in English, Danish, Norwegian, or Swedish were eligible for inclusion. Data were extracted independently by two reviewers (SMA and SS) and narratively synthesized utilizing content analysis ad modum Kriffendorff [6]. The protocol was registered at Open Science Framework (10.17605/OSF.IO/HVU54).

Results: Of 5,690 records, 743 underwent full-text screening, and eight met the inclusion criteria (see Figure 1 for a flow diagram of the identification and screening process). The included studies represented qualitative (n=3), quantitative (n=3), mixed-method (n=1), and service-evaluation (n=1) designs conducted across rheumatology, primary care, and community settings. Participants were adults living with autoimmune diseases, including rheumatoid arthritis, other inflammatory arthritis, systemic lupus, and diabetes 1. SP interventions varied and included multidisciplinary services integrating social prescribing principles, systematic screening for social needs, patient navigator programs, behavioral or psychosocial support delivered in primary care, community connector models with home visits, and nature-based group activities. Access Access refers to factors influencing entry into social prescribing and was strengthened when psychosocial needs were identified early and incorporated into routine assessments. Multidisciplinary collaboration, systematic screening and practical support such as transport further facilitated access. Barriers included fragmented care pathways, limited referral options and socioeconomic constraints. Uptake Uptake refers to acceptance of referral to social prescribing, which was highest when SP was person-centered, flexible, and responsive to fluctuating symptoms and daily routines. Supportive relationships with link workers or navigators and safe group settings encouraged engagement. Fatigue, pain, psychological distress, stigma, and language barriers hindered uptake. Retention Retention refers to factors influencing sustained involvement in social prescribing. Retention was supported by continuity of contact, regular follow-up, and relational approaches that fostered motivation and a sense of progress. Fluctuating disease activity, mental health challenges, short program durations, and organizational constraints limited sustained involvement. Effect Evidence on factors influencing effect was limited. Reported effects were mainly improvements in wellbeing, social connectedness, coping, and self-efficacy, together with increased engagement in meaningful activities. Across the eight studies, three factors consistently shaped both access, uptake, and retention: flexibility to symptom fluctuations, relational continuity, and integrated care. See Figure 2 for an overview of key factors influencing engagement in social prescribing for people with rheumatic diseases.

Conclusions: SP appears to hold promise as a complementary and person-centered approach for adults living with autoimmune rheumatic diseases. Evidence suggests that accessible, flexible and well-integrated SP interventions facilitate engagement and may create conditions that support psychosocial wellbeing. Key facilitators included sensitivity to symptom variation, continuity of support and clear pathways between health and community services, while organizational constraints and fluctuating disease activity limited opportunities for benefit. The evidence base remains limited and heterogeneous. Future research should examine how SP can be implemented within rheumatology care, identify components that enable meaningful engagement and assess longer term psychosocial and clinical outcomes.

REFERENCES: [1] DOI: 10.1093/rheumatology/keae471.

[2] DOI: 10.1111/1756-185X.70041.

[3] DOI: 10.1186/s12875-025-02997-6.

[4] DOI: 10.11124/JBIES-20-00167.

[5] DOI: 10.7326/M18-0850.

[6] DOI: 10.4135/9781071878781.

Acknowledgments: NIL.

Disclosure of interest: Signe Marie Abild: None declared, sofie schuster: None declared, Julie Midtgaard: None declared, Mette Aadahl: None declared, Bente Glintborg Research grants were paid to the institution by AbbVie, Sandoz, AlfaSigma, and BMS, with no involvement in or influence on the present study., Bente Appel Esbensen: None declared.