Dr Judy Lowthian is the Principal Research Fellow at the Bolton Clarke Research Institute, formerly known as RSL Care + Royal District Nursing Service Research Institute. She also holds an appointment at the School of Public Health and Preventive Medicine at Monash University and an honorary appointment with Alfred Health.
Her research is underpinned by an allied health background and her specific interest is health services research designed to improve the quality and safety of care for older people. In the past five years, Judy has been the recipient of $2.6M in competitive grants and prizes/awards. She serves on national and international committees that focus on improving geriatric emergency care.
HOW R U?: telephone peer-support to reduce loneliness after discharge
Older people presenting to an emergency department (ED) are at increased risk of feeling socially isolated, lonely or depressed; all of which are associated with negative health outcomes, functional decline, institutionalisation, mortality and increased health service use.
To ascertain the feasibility and acceptability of HOspital and patients Working in Unity: HOW R U?, a novel post-discharge telephone peer support program delivered by hospital volunteers to older community-dwelling patients with feelings of social isolation, loneliness or depression.
A pragmatic prospective mixed methods study conducted with a cohort of patients aged 70 years or more, with symptoms of loneliness or depression following discharge from the EDs of two tertiary hospitals in Melbourne. Supportive telephone calls were delivered weekly over 3-months by matched volunteer-peers.
Primary outcomes were feasibility of study processes, intervention acceptability, and retention in the program. Secondary outcomes were changes in loneliness level (UCLA-3 item Loneliness Scale), mood (GDS-5 item) and health-related quality of life (EQ-VAS).
The pilot demonstrated feasibility of recruitment with 30% of eligible patents recruited (n=39). Seventeen volunteer peers provided telephone-based social support to patient participants, in addition to usual hospital volunteer roles. The intervention was well-received, with 87% retention in the patient group, and no attrition in the volunteer group.
The median patient age was 84 years, 64% were female and 82% lived alone. The results were encouraging, with 68% and 53% of participants experiencing statistically significant reductions in depressive symptoms and feelings of loneliness, respectively.
Patient feedback was positive: (e.g.) ‘telephone calls are a good way to receive social support without having to go out’; ‘it is empowering to talk to someone when you’re down, and know that you are not alone’; ‘after discharge is when you really need it, if you’re on your own’; ‘my peer was supportive and understanding’. In addition, there was a trend towards reduced ED re-attendance over the 3-month study period. All volunteers reported great satisfaction with their new role.
HOW R U? was feasible in terms of recruitment and retention and was acceptable to both patients and volunteers. The overall results support the potential for further research in this area, and provide data to support the design of a definitive trial to confirm the observed effects.