Benefits of supportive strategies for carers of people with high-grade glioma: a systematic review

Abstract

Purpose To systematically review and examine current evidence for the carer-reported benefits of supportive care strategies for carers of adults with high-grade glioma (HGG). Methods Four databases (CINAHL, EMBASE, PubMed, PsycINFO) were searched for articles published between January 2005 and April 2022 that assessed strategies for addressing the supportive care needs of carers of adults with HGG (WHO grade 3–4). Study selection and critical appraisal were conducted independently by three authors (DJ/MC, 2021; DJ/RJ 2022). Data extraction was conducted by one author (DJ) and checked by a second author (RJ). Results were synthesised narratively. Results Twenty-one studies involving 1377 caregivers were included, targeting the carer directly (n = 10), the patient-carer dyad (n = 3), or focused on people with HGG + / − their carers (n = 8). A paucity of high-quality evidence exists for effective and comprehensive support directly addressing outcomes for carers of adults with HGG. Strategies that demonstrated some benefits included those that built carer knowledge or provided emotional support, delivered by health professionals or through peer support. Supportive and early palliative care programmes have potential to reduce unmet carer needs while providing ongoing carer support. Conclusion Strategies incorporating an educational component, emotional support, and a regular needs assessment with corresponding tailored support are most valued by carers. Future practice development research should adopt a value-based approach and exceed evaluation of efficacy outcomes to incorporate evaluation of the experience of patients, carers, and staff, as well as costs.

Management and outcomes of glioblastoma: 20‐year experience in a single Australian institution

“…There are potentially other factors, beyond the evaluated changes in treatment patterns, that may be associated with the improved outcomes observed over the study period. It is important to note the increasing recognition of the role of palliative care and supportive care services in the management GBM, 29,30 which is now incorporated in the Optimal Care Pathway for GBM, 31 and there is evidence that early integration of palliative care may be associated with improved survival in patients with advanced cancers 32 …”

“…15,28 There are potentially other factors, beyond the evaluated changes in treatment patterns, that may be associated with the improved outcomes observed over the study period. It is important to note the increasing recognition of the role of palliative care and supportive care services in the management GBM, 29,30 which is now incorporated in the Optimal Care Pathway for GBM, 31 and there is evidence that early integration of palliative care may be associated with improved survival in patients with advanced cancers. 32 One of the strengths of the study was that the OS outcomes in our study were obtained through routine data linkage with the Victorian Cancer Registry (VCR) at regular interval, which allowed us to accurately capture OS data, even when patients were no longer followed in our department post-treatment.…”