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Research ArticleOriginal Research

Loneliness in Primary Care Patients: A Prevalence Study

Rebecca A. Mullen, Sebastian Tong, Roy T. Sabo, Winston R. Liaw, John Marshall, Donald E. Nease, Alex H. Krist and John J. Frey
The Annals of Family Medicine March 2019, 17 (2) 108-115; DOI: https://doi.org/10.1370/afm.2358
Rebecca A. Mullen
1Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado
MD, MPH
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  • For correspondence: rebecca.mullen@ucdenver.edu
Sebastian Tong
2Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
MD, MPH
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Roy T. Sabo
2Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
3Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia
PhD
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Winston R. Liaw
4Department of Health Systems and Population Heath Sciences, University of Houston, Houston, Texas
5Robert Graham Center Policy Studies in Family Medicine & Primary Care, Washington, DC
MD, MPH
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John Marshall
2Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
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Donald E. Nease Jr
1Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado
MD
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Alex H. Krist
2Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
MD, MPH
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John J. Frey III
6Department of Family Medicine and Community Health, The University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
MD
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Abstract

PURPOSE Loneliness has important health consequences. Little is known, however, about loneliness in primary care patient populations. This study describes the prevalence of loneliness in patients presenting for primary care and associations with self-reported demographic factors, health care utilization, and health-related quality of life.

METHODS We conducted cross-sectional surveys of adults presenting for routine care to outpatient primary care practices in 2 diverse practice-based research networks. The 3-item University of California, Los Angeles Loneliness Scale was utilized to determine loneliness.

RESULTS The prevalence of loneliness was 20% (246/1,235). Loneliness prevalence was inversely associated with age (P <.01) and less likely in those who were married (P <.01) or employed (P <.01). Loneliness was more common in those with lower health status (P <.01), including when adjusting for employment and relationship status (odds ratio [OR] = 1.05; 95% CI, 1.03-1.07). Primary care visits (OR = 1.07; 95% CI, 1.03-1.10), urgent care/emergency department visits (OR = 1.24; 95% CI, 1.12-1.38), and hospitalizations (OR = 1.15; 95% CI, 1.01-1.31) were associated with loneliness status. There was no significant difference in rates of loneliness between sexes (P = .08), racial categories (P = .57), or rural and urban respondents (P = .42).

CONCLUSIONS Our findings demonstrate that loneliness is common in primary care patients and is associated with adverse health consequences including poorer health status and greater health care utilization. Further work is needed to understand the value of screening for and using interventions to treat loneliness in primary care.

Key words
  • loneliness
  • 3-item UCLA Loneliness Scale
  • primary care
  • prevalence
  • Received for publication August 16, 2018.
  • Revision received November 4, 2018.
  • Accepted for publication November 28, 2018.
  • © 2019 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 17 (2)
The Annals of Family Medicine: 17 (2)
Vol. 17, Issue 2
March/April 2019
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Loneliness in Primary Care Patients: A Prevalence Study
Rebecca A. Mullen, Sebastian Tong, Roy T. Sabo, Winston R. Liaw, John Marshall, Donald E. Nease, Alex H. Krist, John J. Frey
The Annals of Family Medicine Mar 2019, 17 (2) 108-115; DOI: 10.1370/afm.2358

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Loneliness in Primary Care Patients: A Prevalence Study
Rebecca A. Mullen, Sebastian Tong, Roy T. Sabo, Winston R. Liaw, John Marshall, Donald E. Nease, Alex H. Krist, John J. Frey
The Annals of Family Medicine Mar 2019, 17 (2) 108-115; DOI: 10.1370/afm.2358
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Subjects

  • Domains of illness & health:
    • Mental health
  • Person groups:
    • Older adults
    • Vulnerable populations
  • Methods:
    • Quantitative methods
  • Other research types:
    • Health services
  • Core values of primary care:
    • Personalized care
    • Relationship
  • Other topics:
    • Social / cultural context
    • Patient perspectives

Keywords

  • loneliness
  • 3-item UCLA Loneliness Scale
  • primary care
  • prevalence

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