From prescription to practice: improving patient access and adherence to nature-based clinical interventions

Background: Rooted in historical healing traditions and backed by growing clinical evidence, nature-based prescriptions (GRx) are gaining recognition as low-cost, multifaceted strategies to improve disease prevention. These prescriptions encourage healthcare practitioners to harness the curative properties of nature through structured regimes. However, while many countries have piloted successful GRx programs, widespread integration into clinical practice remains limited, especially in vulnerable communities. Objective: We conducted a narrative review synthesizing existing evidence to examine the gap between clinician-initiated GRx and practice. We particularly focus on healthcare system integration, adherence, and equity considerations. Methods: Sources were identified using academic databases including Google Scholar, Scopus and PubMed alongside gray literature such as government documents and private programs. Evidence was synthesized narratively to identify recurring implementation-relevant patterns across clinical, environmental, and patient-level contexts. Results: Our review found that despite the growing adoption of GRx, their integration into routine clinical practice remains largely stagnant. This has largely been due to recurring patterns related to structured frameworks, limited clinical infrastructure, and inequitable access to greenspace. Across all settings, patient follow-through is consistently hindered due to transportation, safety and time constraints, further exacerbated by environmental and socioeconomic barriers. Based on recurring patterns identified in literature, we propose a practice-informed call-to-action framework grounded in three pillars: access to resources, value and return on investment, and accountability. Conclusion: By expanding resource access, embedding GRx into clinical workflows, building cross-sector partnerships and strengthening accountability mechanisms, GRx can move beyond its niche status to become a scalable, equitable, and standardized part of preventive care.