The Impact of a Befriending Service on Health-related Quality of Life in Older Adults: An Interventional N-of-1 Pilot Study.

Purpose: Befriending interventions are unlikely to reduce loneliness, but they may provide social support which buffers the negative impact of loneliness on health outcomes of older adults. An interventional N-of-1 design was used to assess the impact of a befriending intervention on health-related quality of life (HR-QoL) among older adults, and whether such intervention attenuated the impact of loneliness on HR-QoL. Methods: Participants were n = 33 new users of the service, aged 60+. Outcomes were measured at 13 timepoints across 26 weeks, and data were analysed using generalised additive modelling (GAM) with a subset of data analysed using visual analysis. Results: Results indicate that the befriending service may reduce decline of HR-QoL (i.e., health declined in the baseline phase over time: edf = 3.893, F = 3.0, p=0.002, while in the treatment phase, health remained more stable: edf = 5.98, F = 2.98, p=.008). The befriending intervention also suppressed the association between loneliness and HR-QoL. Conclusion: We supported our hypothesis, that befriending interventions may moderate the impact of loneliness on HR-QoL. Interventional N-of-1 designs however carry considerable recruitment and participant burden, which should be considered prior to onset. This research provides an insight into practical difficulties when evaluating existing community-based services, particularly in relation to adhering to best practice design guidelines.