An evaluation of interventions to improve outcomes for hospitalized patients in isolation: A systematic review.

Abstract Background Isolation is effective in preventing transmission of infectious disease. However, it has been shown to have negative effects including increased anxiety and poor physical outcomes. Objectives To summarize the effects of interventions to improve safety and outcomes for patients in isolation Design Systematic review (PROSPERO protocol registration-CD CRD42020222779). Setting Acute hospital Participants Intervention studies including patients in preventative or protective isolation in a single room. Methods MEDLINE, Global Health, CINAHL, PsycINFO, and EMBASE were searched from 1996-October 2020. Two independent reviewers screened references and assessed risk of bias. One reviewer extracted data and was checked by another. Main outcomes were Quality of Life and mortality. Results We identified 16,698 references and included 6 studies with different study designs. Average age ranged from 4-71 years. Samples sizes were small (range 10-49 participants) apart from one non-randomized controlled trial including >600 participants. Interventions were music therapy (n=3), psychological counseling (n=2) and exercise training (n=1). One study reporting on Quality of Life and found no change after exercise. None of the studies reported on mortality. Due to heterogeneous results no meta-analyses were performed. Conclusions There is a lack of high-quality evidence for effective comprehensive interventions to manage adverse effects associated with isolation. Future studies should investigate the effect of multi-component interventions using rigorous methods to improve outcomes for hospitalized isolated patients.