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Systematic Review
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.
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 measured symptoms of depression using the Geriatric Depression Scale. Total scores range from 0 (better) to 30 (worse). The evidence was very uncertain and suggests that video calls may result in little to no difference in scores on the Geriatric Depression Scale compared to usual care at three months' follow‐up (MD 0.41, 95% CI −0.90 to 1.72; 3 studies; 201 participants) or six months' follow‐up (MD −0.83, 95% CI −2.43 to 0.76; 2 studies, 152 participants). The evidence suggests that video calls may have a small effect on symptoms of depression at one‐year follow‐up, though this finding is imprecise (MD −2.04, 95% CI −3.98 to −0.10; 1 study; 90 participants). We downgraded the certainty of this evidence by three levels for study limitations, imprecision and indirectness.
Only one study, with 62 participants, reported quality of life. The study measured quality of life using a Taiwanese adaptation of the Short‐Form 36‐question health survey (SF‐36), which consists of eight subscales that measure different aspects of quality of life: physical function; physical role; emotional role; social function; pain: vitality; mental health; and physical health. Each subscale is scored from 0 (poor health) to 100 (good health). The evidence is very uncertain and suggests that there may be little to no difference between people allocated to usual care and those allocated to video calls in three‐month scores in physical function (MD 2.88, 95% CI −5.01 to 10.77), physical role (MD −7.66, 95% CI −24.08 to 8.76), emotional role (MD −7.18, 95% CI −16.23 to 1.87), social function (MD 2.77, 95% CI −8.87 to 14.41), pain scores (MD −3.25, 95% CI −15.11 to 8.61), vitality scores (MD −3.60, 95% CI −9.01 to 1.81), mental health (MD 9.19, 95% CI 0.36 to 18.02) and physical health (MD 5.16, 95% CI −2.48 to 12.80). We downgraded the certainty of this evidence by three levels for study limitations, imprecision and indirectness.
Based on this review there is currently very uncertain evidence on the effectiveness of video call interventions to reduce loneliness in older adults. The review did not include any studies that reported evidence of the effectiveness of video call interventions to address social isolation in older adults. The evidence regarding the effectiveness of video calls for outcomes of symptoms of depression was very uncertain.
Future research in this area needs to use more rigorous methods and more diverse and representative participants. Specifically, future studies should target older adults, who are demonstrably lonely or socially isolated, or both, across a range of settings to determine whether video call interventions are effective in a population in which these outcomes are in need of improvement.