TY - JOUR

T1 - Effect of home-based specialised palliative care and dyadic psychological intervention on caregiver anxiety and depression

T2 - a randomised controlled trial

AU - von Heymann-Horan, Annika

AU - Bidstrup, Pernille

AU - Guldin, Mai Britt

AU - Sjøgren, Per

AU - Andersen, Elisabeth Anne Wreford

AU - von der Maase, Hans

AU - Kjellberg, Jakob

AU - Timm, Helle

AU - Johansen, Christoffer

PY - 2018

Y1 - 2018

N2 - Background: Specialised palliative care trials often fail to address intervention effects on caregiver anxiety and depression, particularly in bereavement. We evaluate effects of specialised palliative care and dyadic psychological intervention on caregiver anxiety and depression in a randomised controlled trial (RCT). Methods: Patients with incurable cancer and limited antineoplastic treatment options and their caregivers, recruited from a university hospital oncology department, were randomised (1:1) to care as usual or accelerated transition from oncological treatment to home-based specialised palliative care. We assessed caregivers’ symptoms of anxiety and depression with the Symptom Checklist-92 up to six months after randomisation and 19 months into bereavement, and estimated intervention effects in mixed effects models. Results: The ‘Domus’ trial enrolled 258 caregivers. The intervention significantly attenuated increases in caregivers’ symptoms of anxiety overall (estimated difference, −0.12; 95% confidence interval, −0.22 to −0.01, p = 0.0266), and symptoms of depression at eight weeks (−0.17; −0.33 to −0.02; p = 0.0314), six months (−0.27; −0.49 to −0.05; p = 0.0165), and in bereavement at two weeks (−0.28; −0.52 to −0.03; p = 0.0295) and two months (−0.24; −0.48 to −0.01; p = 0.0448). Conclusions: This first RCT evaluating specialised palliative care with dyadic psychological support significantly attenuated caregiver anxiety and depression before and during bereavement. (Clinicaltrials.gov: NCT01885637).

AB - Background: Specialised palliative care trials often fail to address intervention effects on caregiver anxiety and depression, particularly in bereavement. We evaluate effects of specialised palliative care and dyadic psychological intervention on caregiver anxiety and depression in a randomised controlled trial (RCT). Methods: Patients with incurable cancer and limited antineoplastic treatment options and their caregivers, recruited from a university hospital oncology department, were randomised (1:1) to care as usual or accelerated transition from oncological treatment to home-based specialised palliative care. We assessed caregivers’ symptoms of anxiety and depression with the Symptom Checklist-92 up to six months after randomisation and 19 months into bereavement, and estimated intervention effects in mixed effects models. Results: The ‘Domus’ trial enrolled 258 caregivers. The intervention significantly attenuated increases in caregivers’ symptoms of anxiety overall (estimated difference, −0.12; 95% confidence interval, −0.22 to −0.01, p = 0.0266), and symptoms of depression at eight weeks (−0.17; −0.33 to −0.02; p = 0.0314), six months (−0.27; −0.49 to −0.05; p = 0.0165), and in bereavement at two weeks (−0.28; −0.52 to −0.03; p = 0.0295) and two months (−0.24; −0.48 to −0.01; p = 0.0448). Conclusions: This first RCT evaluating specialised palliative care with dyadic psychological support significantly attenuated caregiver anxiety and depression before and during bereavement. (Clinicaltrials.gov: NCT01885637).

U2 - 10.1038/s41416-018-0193-8

DO - 10.1038/s41416-018-0193-8

M3 - Journal article

C2 - 30425351

AN - SCOPUS:85056637885

VL - 119

SP - 1307

EP - 1315

JO - The British journal of cancer. Supplement

JF - The British journal of cancer. Supplement

SN - 0007-0920

ER -