Loneliness Linked to Increased Emergency Department Visits Among Patients With COPD

Loneliness may be independently associated with more emergency department (ED) visits and worse perception of health among patients with chronic obstructive pulmonary disease (COPD), according to a recent study.

Individuals with COPD commonly suffer from psychologic comorbidities, including anxiety, depression and loneliness. The researchers used baseline data from a previously published trial—National Emphysema Treatment Trial (NETT)—which included a measure of loneliness through the Quality of Wellbeing questionnaire. NETT also investigated the effectiveness of lung volume reduction surgery in patients with moderate-to-severe COPD.

“Loneliness, in particular, is a significant obstacle for individuals living with COPD, as well as an overall public health concern. Loneliness can be defined as the feeling that one's social relations are inadequate, leading to subjective dissatisfaction,” the authors explained. “This subsequently may contribute to a sense of distress and has been linked to adverse outcomes in mortality and mental health.”

The study was conducted from December 2002 to December 2004, with a follow-up period of 5 years in order to measure loneliness as well as the use of ED. In total, 1219 patients were evaluated. The average patient age was 65, 47% of patients were women, and 7.9% of patients reported feeling lonely, according to the results.

The patients who reported feeling lonely had worse health ratings, 6-minute walk tests, and breathlessness. After the researchers adjusted for a variety of factors, including age, lung function, and dyspnea, loneliness was found to be independently associated with ED visits.

“Our study demonstrates that loneliness is related to worse perception of general health from the patient perspective, and it is possible that even married patients experience feelings of social isolation,” the study noted. “It is plausible that addressing loneliness in the outpatient setting may ultimately contribute to decreased ED visits and improved quality of life for this population by improving perceptions of health.”

The researchers suggest an increase in engagement of activities for this COPD population is necessary in order to help minimize loneliness. Also, the report demonstrated the need for frequent assessment of loneliness during routine practice.

Reference

Marty P, Novotny P, Benzo R. Loneliness and ED visits in chronic obstructive pulmonary disease [published online August 23, 2019]. Mayo Clin Proc Innov Qual Outcomes. doi: 10.1016/j.mayocpiqo.2019.05.002.