A proactive phone intervention for older adults to address loneliness identified by a health plan.

Social isolation and loneliness are associated with poor health and higher health care costs among older adults. Our objective was to determine if older adults identified as at risk for loneliness by a Medicare Advantage health plan could benefit from a proactive telephone support program. We conducted a mixed-methods pilot efficacy study of outbound calls from an established community-based telephone program to support older adults identified as at risk for loneliness. One hundred and twenty-one older adults were enrolled and completed surveys at baseline, 3 months, and 6 months. Outcomes included loneliness (3-item UCLA loneliness scale), depression (PHQ-2 screen), anxiety (GAD-2 screen), and unhealthy physical and mental health days (CDC Healthy Days Measure). Quantitative data were analyzed using multivariable mixed-effects logistic regression, and open-ended responses were analyzed thematically. Over 6 months, participants had reductions in loneliness (46% to 28%, p<0.001), depression (36% to 25%, p = 0.07), anxiety (63% to 43%, p = 0.004), unhealthy mental days (14 to 8, p<0.001), and unhealthy physical days (15 to 11, p<0.001). Participants reported high satisfaction with calls, and many felt the calls improved overall mood or health. Findings can inform trials to address loneliness through telephone support and partnerships between community-based organizations and payors.

What Are "Social Prescriptions" and How Should They Be Integrated Into Care Plans?

Health consequences of social isolation and loneliness include worsened morbidity and mortality. Despite wide recognition of this fact, little is understood about how to intervene successfully. "Social prescribing" is one approach by which clinicians can intervene on social determinants of health, which include social isolation and loneliness. This commentary on a case defines social prescribing and suggests how to integrate it into practice.