Patients with heart failure who describe themselves as being “socially isolated” have an increased risk of death and also have an increased use of healthcare resources, according to new research published in the Journal of the American Heart Association on May 23.
“Our study found a patient’s sense of feelings of loneliness or isolation, may contribute to poor prognosis in heart failure,” said study senior author Lila Rutten, PhD, professor of the Mayo Clinic in Rochester, Minnesota, in a press release. “Healthcare providers may aid their heart failure patients by implementing a valid, reliable and brief screening tool to help identify those who are experiencing social isolation.”
The researchers surveyed more than 3,800 patients from 11 southeast Minnesota counties with over the span of a little more than two years using the PROMIS Social Isolation Short Form. Of the 2,003 patients who responded to the survey, 1,681 patients were used as the final study cohort. Approximately 19 percent of the cohort reported moderate perceived social isolation and 6 percent had a high perceived social isolation.
Patients who self-reported high perceived social isolation had more than 3.5 times increased risk of death, had a 68 percent increased risk of hospitalization and a 57 percent increased risk of emergency department visits.
Patients who self-reported moderate perceived social isolation did not have an increased risk of death, hospitalizations or emergency department visits.
Compared with patients who self-reported low perceived social isolation, those who reported a moderate perceived social isolation had a 16 percent increased risk of outpatient visits, and those who reported high perceived social isolation had a 26 percent increased risk.
During an average follow-up of eight months, there were 533 hospitalizations, 1,000 emergency visits and 59 deaths. The researchers noted among the cohort, greater perceived social isolation was associated with an increased risk of death.
Future research is needed to better understand why perceived social isolation leads to poorer outcomes, the authors said. Though they recommend clinicians assess perceived social isolation during clinical encounters to identify patients who feel isolated as this can help manage their disease and improve outcomes.
Where there have been several self-care interventions in heart failure, the effect of self-care on preventing mortality in previous work has been inconsistent. But there is evidence that suggests self-care interventions can help prevent hospitalizations in patients with heart failure.
“Perceived social isolation may be the result of individual, circumstantial, or environmental conditions or some combination thereof,” the authors concluded. “Therefore, means to address perceived social isolation will vary accordingly, and may involve referral to psychological or social services, establishing connections with community resources, or referral to specialized services to meet patient needs.”
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.