Green health prescribing for adults 50+: systematic review of health and social outcomes
A systematic review of 21 studies, 11 of them randomised trials, found many reported improvements but few statistically significant effects versus controls; certainty was low or very low. [1]
Automatic summary · not editorially reviewed
The key findings
The review covered adults aged 50 years and over in primary or community care settings. [1]
Twenty-one studies, including 11 randomised trials, were included; significant effects versus controls were uncommon. [1]
Certainty of evidence was low or very low, and the authors call for pragmatic trials and implementation studies. [1]
The source at a glance
- Study type / format
- Systematic review of intervention studies (abstract)
- Population / context
- Adults aged 50 years and over living in the community or residential care
- Summary based on
- Study abstract
- Original publication
- October 1, 2026
Review question: nature-based prescribing for adults 50 and over
The review asked whether Green Health Prescribing and related nature-based interventions work for adults aged 50 years and over in primary or community care settings. Such prescribing means health and care professionals prescribing structured activities in nature, for example gardening, walking in green spaces or cultural activities outdoors. The authors note that population ageing and pressure on healthcare systems have made this a proposed potentially cost-effective way to support healthy ageing in older adults with long-term conditions.
Supporting source [1]
21 studies, 11 randomised trials, mostly inconsistent results
The review included 21 studies, 11 of them randomised trials, of interventions among older adults living in the community or residential care. Activities included time in nature, exercise in green spaces, indoor gardening and horticultural therapy. Many studies reported improvement in at least one health or wellbeing outcome, but statistically significant effects compared with control conditions were uncommon. Potential benefits were suggested for quality of life, mental health, physical function, fatigue, loneliness and social connectedness, yet findings were inconsistent.
Supporting source [1]
Low certainty and a call for pragmatic trials
Overall certainty of evidence was low or very low, largely because of small sample sizes, risk of bias and limited replication across outcomes. The authors conclude that evidence for effectiveness remains limited. They call for high-quality pragmatic trials and implementation studies, particularly among older adults, to assess health outcomes, cost-effectiveness and healthcare resource use in routine practice for Green Health Prescribing as a referral option in primary and community care.
Supporting source [1]
How to interpret this
Abstract only; the full text was not reviewed. The review itself reports low or very low certainty, small samples, risk of bias and limited replication. Reported improvements are associations, not proof of cause.
Based on the study abstract; the full paper, tables and supplementary data were not reviewed.
Source & supporting passages
Butt F, Donoghue J, Ley C, Dracup N, Staniszewska S, Al-Khudairy L, Smith TM, Corp N, Parsons J, Frost H, Grove A, Chen YF, van der Windt DA. · europepmc.org · October 1, 2026