Technology-Assisted mHealth Caregiver Support to Manage Cancer Patient Symptoms: A Randomized Controlled Trial

Mooney, Kathi; Whisenant, Meagan; Wilson, Christina; Coombs, Lorinda A; Lloyd, Jennifer; Alekhina, Natalya; Sloss, Elizabeth A.; Steinbach, Mary; Moraitis, Ann Marie; Berry, Patricia; Iacob, Eli; Donaldson, Gary

doi:10.1016/j.jpainsymman.2023.02.320

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…Our findings demonstrated both robust statistically significant and clinically meaningful benefits for the maintenance of caregiver well‐being. This is paired with our previously reported results demonstrating that the SCH caregiver intervention reduced patient symptom burden over UC 14 . Our findings indicate significant improvement can be obtained in caregiver well‐being when interventions such as SCH are added to usual hospice care.…”

Section: Discussionsupporting

confidence: 89%

“…This is paired with our previously reported results demonstrating that the SCH caregiver intervention reduced patient symptom burden over UC. 14 Our findings indicate significant improvement can be obtained in caregiver well-being when interventions such as SCH are added to usual hospice care. SCH served as a protective intervention for caregivers (Figure 2), helping maintain both mood and vitality, compared to the trajectory of increasing burden, depressed mood, and loss of vitality associated with UC.…”

Section: Discussionmentioning

confidence: 62%

“…We hypothesized that SCH caregivers would have reduced caregiving and bereavement burden when compared with usual cancer hospice care. Patient outcomes related to the SCH intervention have been reported elsewhere 14 …”

Section: Introductionmentioning

confidence: 99%

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Impact of an automated, remote monitoring and coaching intervention in reducing hospice cancer family caregiving burden: A multisite randomized controlled trial

Mooney,

Coombs,

Whisenant

et al. 2023

Cancer

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BackgroundCare for those with life‐limiting cancer heavily involves family caregivers who may experience significant physical and emotional burden. The purpose of this study was to test the impact of Symptom Care at Home (SCH), an automated digital family caregiver coaching intervention, during home hospice, when compared to usual hospice care (UC) on the primary outcome of overall caregiver burden. Secondary outcomes included Caregiver Burden at weeks 1 and 8, Mood and Vitality subscales, overall moderate‐to‐severe caregiving symptoms, and sixth month spouse/partner bereavement outcomes.MethodsUsing a randomized, multisite, nonblinded controlled trial, 332 cancer family caregivers were enrolled and analyzed (159 SCH vs. 173 UC). Caregivers were primarily White (92%), female (69%), and spouse caregivers (53%). Caregivers provided daily reports on severity levels (0–10 scale) for their anxiety, depressed mood, fatigue, disturbed sleep, and caregiving interference with normal activities. These scores combined constituted the Caregiver Burden primary outcome. Based on reported symptoms, SCH caregivers received automated, tailored coaching about improving their well‐being. Reports of moderate‐to‐severe caregiving symptoms also triggered hospice nurse notification. Secondary outcomes of Mood and Vitality were subcomponents of the Caregiver Burden score. A combined bereavement adjustment tool captured sixth month bereavement.ResultsThe SCH intervention reduced overall Caregiver Burden compared to UC (p < .001), with a 38% reduction at 8 weeks and a medium‐to‐large effect size (d = .61). SCH caregivers experienced less (p < .001) disruption in both Mood and Vitality. There were higher levels of moderate‐to‐severe caregiving symptoms overtime in UC (OR, 2.722). All SCH caregivers benefited regardless of caregiver: sex, caregiver relationship, age, patient diagnosis and family income. SCH spouse/partner caregivers achieved better sixth month bereavement adjustment than UC (p < .007).ConclusionsThe SCH intervention significantly decreased caregiving burden over UC and supports the maintenance of family caregiver mood and vitality throughout caregiving with extended benefit into bereavement.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 62%