The contribution of primary care practitioners to interventions reducing loneliness and social isolation in older people—An integrative review

Abstract

BackgroundSocial connection is a fundamental human need. Its absence can lead to loneliness and social isolation, adversely impacting health and well‐being. Given their regular contact and trusted relationships with older people, practitioners delivering community‐based primary care are well‐positioned to address this issue. However, their contribution to addressing loneliness and social isolation is unclear.AimThis integrative review explores the contribution of the primary care workforce to interventions aimed at reducing loneliness and social isolation in community‐dwelling older people.MethodUsing an integrative review method, Scopus, Web of Science, CINAHL and PubMed were searched for original research published between 2000 and 2022. Fourteen papers reporting 13 primary studies were appraised for methodological quality and included in the review. Data were extracted into a summary table and analysed using thematic analysis.ResultsIncluded studies came from over six countries. Internationally, primary care services have diverse structures, funding and workforces influencing their response to loneliness and social isolation. All but one intervention was multi‐component, with ten studies including a group‐based activity and three providing primarily individual‐level activities. Only six studies reported reductions in loneliness following the intervention. Three themes were identified: characteristics of interventions; implementation context, barriers and facilitators; and differing contributions of primary care practitioners in addressing loneliness and social isolation of older people.ConclusionThere is increasing demand and scope for primary care practitioners to assist lonely and socially isolated older people. It is important to understand how to equip and incentivise these practitioners to routinely identify, assess and respond to lonely and socially isolated older people despite varying implementation contexts. There is a need for further research that explores how the primary care team can be better utilised to deliver effective interventions that reduce the health impacts of loneliness and social isolation.

Interventions in ambulatory healthcare settings to reduce social isolation among adults aged 18–64: a systematic review

“…Primary care settings are often the first point of contact between a patient and the healthcare system. [18][19][20] Additionally, the provision of long-lasting, continuous care by primary care teams allows them to become a trusted source of health information for patients. 19 To our knowledge, few studies have addressed social isolation interventions among the population under 65.…”

“…[18][19][20] Additionally, the provision of long-lasting, continuous care by primary care teams allows them to become a trusted source of health information for patients. 19 To our knowledge, few studies have addressed social isolation interventions among the population under 65. Thus, in this systematic review, we aimed to identify interventions targeting social isolation in adults aged 18-64 and elucidate the role of ambulatory care settings, particularly primary care settings, in hosting and delivering such interventions.…”

Loneliness and depression in older adults with multimorbidity: the role of self-efficacy and social support

“…Identifying at risk patients by means of loneliness might be easy with short symptom checklists [e.g., TILS -Three Items Loneliness Scale by Hughes et al (63)] or asking corresponding questions. Addressing loneliness can be done by typical tools like connecting patients with each other, helping interaction with relatives and friends or also improving communication with health professionals could help (9,(76)(77)(78)(79). Moreover, healthcare providers may consider implementing interventions to enhance self-efficacy, such as cognitive-behavioral therapy, which has been shown to improve self-efficacy and reduce depressive symptoms at an early point in time (39).…”