Abstract
BackgroundLoneliness in older people is associated with poor health-related quality of life (HRQoL). We undertook a parallel-group randomised controlled trial to evaluate the effectiveness and cost-effectiveness of telephone befriending for the maintenance of HRQoL in older people. An internal pilot tested the feasibility of the trial and intervention.MethodsParticipants aged >74 years, with good cognitive function, living independently in one UK city were recruited through general practices and other sources, then randomised to: (1) 6 weeks of short one-to-one telephone calls, followed by 12 weeks of group telephone calls with up to six participants, led by a trained volunteer facilitator; or (2) a control group. The main trial required the recruitment of 248 participants in a 1-year accrual window, of whom 124 were to receive telephone befriending. The pilot specified three success criteria which had to be met in order to progress the main trial to completion: recruitment of 68 participants in 95 days; retention of 80% participants at 6 months; successful delivery of telephone befriending by local franchise of national charity. The primary clinical outcome was the Short Form (36) Health Instrument (SF-36) Mental Health (MH) dimension score collected by telephone 6 months following randomisation.ResultsWe informed 9,579 older people about the study. Seventy consenting participants were randomised to the pilot in 95 days, with 56 (80%) providing valid primary outcome data (26 intervention, 30 control). Twenty-four participants randomly allocated to the research arm actually received telephone befriending due to poor recruitment and retention of volunteer facilitators. The trial was closed early as a result. The mean 6-month SF-36 MH scores were 78 (SD 18) and 71 (SD 21) for the intervention and control groups, respectively (mean difference, 7; 95% CI, -3 to 16).ConclusionsRecruitment and retention of participants to a definitive trial with a recruitment window of 1 year is feasible. For the voluntary sector to recruit sufficient volunteers to match demand for telephone befriending created by trial recruitment would require the study to be run in more than one major population centre, and/or involve dedicated management of volunteers.Trial registrationISRCTN28645428.
Highlights
Loneliness in older people is associated with poor health-related quality of life (HRQoL)
The PLINY study was commissioned to establish whether a home-based intervention could improve or successfully maintain the mental wellbeing of older people living in the community with a focus upon those who are vulnerable and hard to reach
It was these research findings which informed the design of the PLINY intervention, the evaluation of which we report here
Summary
Loneliness in older people is associated with poor health-related quality of life (HRQoL). Qualitative research reported since the publication of the NICE guidance suggested that telephone befriending services promoted by two UK national charities “helped older people to gain confidence, re-engage with the community and become socially active” [14]. The authors’ recommendation, that initial one-to-one telephone calls with older people might be used to encourage participation in telephone clubs [15], echoed that of an earlier randomised controlled trial (RCT) conducted in the US [16]. It was these research findings which informed the design of the PLINY intervention, the evaluation of which we report here
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