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Loneliness appears to be a more important risk factor for symptom exacerbations and acute health service use among adults with chronic obstructive pulmonary disease (COPD) than asthma, according to study findings published online ahead of print in the Journal of Clinical Psychology in Medical Settings.
“Given the long-term suffering involved among those with COPD, feelings of loneliness may grow more meaningful over time, whereas those with asthma may be less impacted given the acute nature of the symptomology,” wrote corresponding author Patric J. Leukel, PhD, of the University of Mississippi, Oxford, Mississippi, and study coauthors.
The study compared the relative association of loneliness and low social support for respiratory health in people with asthma and COPD. Both factors were previously linked with negative outcomes in this population, but researchers were interested in how each impacted patients.
“Although social support is correlated with loneliness,” they explained, “low social support is neither necessary nor sufficient for the experience of loneliness.”
The study included 206 adults with asthma and 308 adults with COPD. Patients reported symptom exacerbations, hospitalizations, and emergency department visits over the previous 12 months. They also completed the 3-item version of the UCLA Loneliness Scale and the ENRICHD Social Support Inventory.
Researchers expected to find that loneliness and low social support would each increase the odds of exacerbations and acute care use after controlling for respiratory symptom control and other predictors.
However, the study demonstrated greater hospitalization odds for adults with asthma and loneliness but not social support. Moreover, neither loneliness nor social support were associated with exacerbations or the use of other acute care services.
Among adults with COPD, loneliness was associated with greater odds of hospitalization and symptom exacerbation, as researchers had predicted. Contrary to predictions, however, greater social support also significantly increased the likelihood of symptom exacerbation, hospitalization, and emergency department visits in patients with COPD.
“We suggest two possibilities to explain these seemingly paradoxical findings,” researchers wrote. “First, it is likely that family members and friends provide more support to individuals with more severe respiratory symptoms who are also more likely to experience symptom exacerbations and use acute medical services. Second, these supporters may facilitate their support recipients’ use of emergency medical care, which may subsequently increase their likelihood of hospitalizations.”
