Video calls for reducing social isolation and loneliness in older people: a rapid review

Cochrane Public Health Group… - Cochrane Database …, 1996 - cochranelibrary.com
Cochrane Public Health Group, C Noone, J McSharry, M Smalle, A Burns, K Dwan…
Cochrane Database of Systematic Reviews, 1996cochranelibrary.com
Background The current COVID‐19 pandemic has been identified as a possible trigger for
increases in loneliness and social isolation among older people due to the restrictions on
movement that many countries have put in place. Loneliness and social isolation are
consistently identified as risk factors for poor mental and physical health in older people.
Video calls may help older people stay connected during the current crisis by widening the
participant's social circle or by increasing the frequency of contact with existing …
Background
The current COVID‐19 pandemic has been identified as a possible trigger for increases in loneliness and social isolation among older people due to the restrictions on movement that many countries have put in place. Loneliness and social isolation are consistently identified as risk factors for poor mental and physical health in older people. Video calls may help older people stay connected during the current crisis by widening the participant’s social circle or by increasing the frequency of contact with existing acquaintances.
Objectives
The primary objective of this rapid review is to assess the effectiveness of video calls for reducing social isolation and loneliness in older adults. The review also sought to address the effectiveness of video calls on reducing symptoms of depression and improving quality of life.
Search methods
We searched CENTRAL, MEDLINE, PsycINFO and CINAHL from 1 January 2004 to 7 April 2020. We also searched the references of relevant systematic reviews.
Selection criteria
Randomised controlled trials (RCTs) and quasi‐RCTs (including cluster designs) were eligible for inclusion. We excluded all other study designs. The samples in included studies needed to have a mean age of at least 65 years. We included studies that included participants whether or not they were experiencing symptoms of loneliness or social isolation at baseline. Any intervention in which a core component involved the use of the internet to facilitate video calls or video conferencing through computers, smartphones or tablets with the intention of reducing loneliness or social isolation, or both, in older adults was eligible for inclusion. We included studies in the review if they reported self‐report measures of loneliness, social isolation, symptoms of depression or quality of life. 
Two review authors screened 25% of abstracts; a third review author resolved conflicts. A single review author screened the remaining abstracts. The second review author screened all excluded abstracts and we resolved conflicts by consensus or by involving a third review author. We followed the same process for full‐text articles.
Data collection and analysis
One review author extracted data, which another review author checked. The primary outcomes were loneliness and social isolation and the secondary outcomes were symptoms of depression and quality of life. One review author rated the certainty of evidence for the primary outcomes according to the GRADE approach and another review author checked the ratings. We conducted fixed‐effect meta‐analyses for the primary outcome, loneliness, and the secondary outcome, symptoms of depression.
Main results
We identified three cluster quasi‐randomised trials, which together included 201 participants. The included studies compared video call interventions to usual care in nursing homes. None of these studies were conducted during the COVID‐19 pandemic. 
Each study measured loneliness using the UCLA Loneliness Scale. Total scores range from 20 (least lonely) to 80 (most lonely). The evidence was very uncertain and suggests that video calls may result in little to no difference in scores on the UCLA Loneliness Scale compared to usual care at three months (mean difference (MD) −0.44, 95% confidence interval (CI) −3.28 to 2.41; 3 studies; 201 participants), at six months (MD −0.34, 95% CI −3.41 to 2.72; 2 studies; 152 participants) and at 12 months (MD −2.40, 95% CI −7.20 to 2.40; 1 study; 90 participants). We downgraded the certainty of this evidence by three levels for study limitations, imprecision and indirectness.
None of the included studies reported social isolation as an outcome.
Each study …
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