IHPME-Led Study Examines How Loneliness Shapes Patient Experience

A team made up of IHPME researchers and students has published findings linking loneliness to patient experiences in primary care.

By: Marielle Boutin

The cross-sectional study, led by Prof. Walter P. Wodchis and published in The Annals of Family Medicine, underscores the need to recognize social connections as a core component of care, not merely a social issue.

Current and former members of the IHPME community round out the research team, including Emily Hamovitch, a student in the Health Systems Research program, Prof. Kaileah McKellar, and Grace Spiro, former IHPME Postdoctoral Fellow and current Assistant Professor at McMaster University.

Data was collected to support Ontario Health Teams with the goal of reporting patient-reported experience and outcome measures (PREMs and PROMs) to help health teams effectively assess and improve care.

According to Prof. Wodchis, involving trainees was essential in building a deep analysis that goes beyond simply required reporting.

“This analysis has provided essential insights on practice recommendations, and the leadership of Ms. Hamovitch on this paper, using robust analyses, ensured that we accurately identified the reported associations,” says Prof. Wodchis. “We are working as a team to understand the social determinants of PREMs and PROMs; Dr. Spiro contributed to this paper and is leading another related study. The trainees gain experience, our team can share insights with stakeholders, and the health system has more evidence to inform practice and policy in Ontario and beyond.”

The research findings were based on a survey of over 2,500 Ontario patients, which found that loneliness was common among 18 per cent of those surveyed. Patient reported feelings of loneliness were consistently linked to negative patient experiences of care, even after adjusting for pre-existing depression, health status, and socioeconomic factors.

Lonely patients reported worse experiences in almost every aspect of care, from coordination and follow-up to feeling heard, understood, and confident managing their health.

While loneliness among patients did not directly affect systemic factors like appointment availability or delivery speed, it appears to set off a critical domino effect. When care feels less supportive, negative experiences can intensify feelings of isolation, creating a cycle that ultimately places pressure on the health system.

“If the encounter with clinicians is exclusively focused on medical concerns without attending to the patient’s wellness needs then responses as to whether they feel heard and understood are going to have lower ratings,” says Prof. Wodchis. “It’s also likely to limit patient engagement and cloud their overall experience of the encounter. Recognizing these underlying issues helps interpret patient feedback and underscores the value of holistic, connection‑focused care.”

An accompanying editorial highlighted the value of screening tools, such as the 3-item UCLA Loneliness Scale, to assist clinicians in recognizing social isolation, and direct patients to interventions such as social prescribing, peer support, and behavioural approaches to help improve patient experience and overall quality of care.

This perspective echoes insights from Prof. Laura Rosella’s work on the Canadian Community Flourishing Survey, which sheds light on the importance of social connection and belonging and how they shape not only health, but how people move through care systems.

“Healthcare is not separate from the social world. Patient experience and outcomes are shaped by whether people feel connected, included, and supported in their communities,” says Prof. Rosella.

Ultimately, this work highlights the importance of approaching healthcare through a holistic lens, recognizing that quality care extends beyond clinical treatment to include connection, emotional wellbeing, and the broader social contexts that shape patient experience.