Factors impacting loneliness in patients with serious life-limiting illness in the Emergency Medicine Palliative Care Access (EMPallA) study

Abstract Background Loneliness is a quality-of-life (QoL) concern for patients facing serious, life-limiting illnesses. Discerning risk factors of loneliness in palliative care patients allows providers to take preventative action and develop holistic treatment plans. Methods A planned sub-study of...

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Main Authors: Brendan Maloney, Mara Flannery, Jason J. Bischof, Kaitlyn Van Allen, Oluwaseun Adeyemi, Keith S. Goldfeld, Allison M. Cuthel, Alex Chang, Corita R. Grudzen
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Palliative Care
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Online Access:https://doi.org/10.1186/s12904-025-01699-1
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author Brendan Maloney
Mara Flannery
Jason J. Bischof
Kaitlyn Van Allen
Oluwaseun Adeyemi
Keith S. Goldfeld
Allison M. Cuthel
Alex Chang
Corita R. Grudzen
author_facet Brendan Maloney
Mara Flannery
Jason J. Bischof
Kaitlyn Van Allen
Oluwaseun Adeyemi
Keith S. Goldfeld
Allison M. Cuthel
Alex Chang
Corita R. Grudzen
author_sort Brendan Maloney
collection DOAJ
description Abstract Background Loneliness is a quality-of-life (QoL) concern for patients facing serious, life-limiting illnesses. Discerning risk factors of loneliness in palliative care patients allows providers to take preventative action and develop holistic treatment plans. Methods A planned sub-study of patients who completed the previously developed Three-Item Loneliness Scale upon enrollment into the multicenter, randomized clinical trial Emergency Medicine Palliative Care Access (EMPallA) with the objective of investigating the association of multimorbidity with loneliness in patients with late-stage illnesses. The EMPallA study included patients who were at least 50 years old and diagnosed with at least one end-stage illness (advanced cancer, advanced congestive heart failure (CHF), end-stage renal disease (ESRD), or advanced chronic obstructive pulmonary disease (COPD)). Results We analyzed 1,212 surveys using a mixed-effects logistic regression model. Our findings suggest those with a single illness are less likely to be lonely than those with multimorbidity (odds ratio [OR] = 0.5, 95% CI 0.3 to 0.8). Additionally, older age was associated with less loneliness (OR comparing age by 10-year increments is 0.7 [95% CI: 0.6 to 0.9]), after adjusting for disease type, education level, race, sex, immigrant status, having a caregiver, COVID-19 period, language, and site geographic location. Conclusions Patients suffering from multimorbidity self-report being “very lonely” more often than patients with a single advanced illness; furthermore, advanced illness patients who were middle-aged (versus elderly) were 25% more likely to report being “very lonely.” Trial registration Clinicaltrials.gov identifier: NCT03325985. Registered October 30, 2017.
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spelling doaj-art-e82c623e52654a4288997987254e8e2c2025-08-20T03:05:46ZengBMCBMC Palliative Care1472-684X2025-03-012411710.1186/s12904-025-01699-1Factors impacting loneliness in patients with serious life-limiting illness in the Emergency Medicine Palliative Care Access (EMPallA) studyBrendan Maloney0Mara Flannery1Jason J. Bischof2Kaitlyn Van Allen3Oluwaseun Adeyemi4Keith S. Goldfeld5Allison M. Cuthel6Alex Chang7Corita R. Grudzen8SUNY Upstate Medical UniversityRonald O. Perelman Department of Emergency Medicine, New York University Grossman School of MedicineDepartment of Emergency Medicine, The Ohio State University Wexner Medical CenterRonald O. Perelman Department of Emergency Medicine, New York University Grossman School of MedicineRonald O. Perelman Department of Emergency Medicine, New York University Grossman School of MedicineDepartment of Population Health, New York University Grossman School of MedicineRonald O. Perelman Department of Emergency Medicine, New York University Grossman School of MedicineCollege of Science, Northeastern UniversityDivision of Supportive and Acute Care Services, Memorial Sloan Kettering Cancer CenterAbstract Background Loneliness is a quality-of-life (QoL) concern for patients facing serious, life-limiting illnesses. Discerning risk factors of loneliness in palliative care patients allows providers to take preventative action and develop holistic treatment plans. Methods A planned sub-study of patients who completed the previously developed Three-Item Loneliness Scale upon enrollment into the multicenter, randomized clinical trial Emergency Medicine Palliative Care Access (EMPallA) with the objective of investigating the association of multimorbidity with loneliness in patients with late-stage illnesses. The EMPallA study included patients who were at least 50 years old and diagnosed with at least one end-stage illness (advanced cancer, advanced congestive heart failure (CHF), end-stage renal disease (ESRD), or advanced chronic obstructive pulmonary disease (COPD)). Results We analyzed 1,212 surveys using a mixed-effects logistic regression model. Our findings suggest those with a single illness are less likely to be lonely than those with multimorbidity (odds ratio [OR] = 0.5, 95% CI 0.3 to 0.8). Additionally, older age was associated with less loneliness (OR comparing age by 10-year increments is 0.7 [95% CI: 0.6 to 0.9]), after adjusting for disease type, education level, race, sex, immigrant status, having a caregiver, COVID-19 period, language, and site geographic location. Conclusions Patients suffering from multimorbidity self-report being “very lonely” more often than patients with a single advanced illness; furthermore, advanced illness patients who were middle-aged (versus elderly) were 25% more likely to report being “very lonely.” Trial registration Clinicaltrials.gov identifier: NCT03325985. Registered October 30, 2017.https://doi.org/10.1186/s12904-025-01699-1Advanced cancerEnd-stage organ failureFunctional declineGeriatricsPalliative carePatient-reported outcomes
spellingShingle Brendan Maloney
Mara Flannery
Jason J. Bischof
Kaitlyn Van Allen
Oluwaseun Adeyemi
Keith S. Goldfeld
Allison M. Cuthel
Alex Chang
Corita R. Grudzen
Factors impacting loneliness in patients with serious life-limiting illness in the Emergency Medicine Palliative Care Access (EMPallA) study
BMC Palliative Care
Advanced cancer
End-stage organ failure
Functional decline
Geriatrics
Palliative care
Patient-reported outcomes
title Factors impacting loneliness in patients with serious life-limiting illness in the Emergency Medicine Palliative Care Access (EMPallA) study
title_full Factors impacting loneliness in patients with serious life-limiting illness in the Emergency Medicine Palliative Care Access (EMPallA) study
title_fullStr Factors impacting loneliness in patients with serious life-limiting illness in the Emergency Medicine Palliative Care Access (EMPallA) study
title_full_unstemmed Factors impacting loneliness in patients with serious life-limiting illness in the Emergency Medicine Palliative Care Access (EMPallA) study
title_short Factors impacting loneliness in patients with serious life-limiting illness in the Emergency Medicine Palliative Care Access (EMPallA) study
title_sort factors impacting loneliness in patients with serious life limiting illness in the emergency medicine palliative care access empalla study
topic Advanced cancer
End-stage organ failure
Functional decline
Geriatrics
Palliative care
Patient-reported outcomes
url https://doi.org/10.1186/s12904-025-01699-1
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