Family CONNECT: A randomised controlled trial to improve psychosocial outcomes for cancer carers. — ASN Events

Family CONNECT: A randomised controlled trial to improve psychosocial outcomes for cancer carers. (#46)

Joanne Shaw 1 2 , Jane Young 1 3 , Phyllis Butow 1 4 , Ivana Durcinoska 1 2 , Tim Badgery-Parker 1 2 , Charbel Sandroussi 1 5 , Patricia Davidson 6 , James Harrison 7 , Michael Solomon 1 8
  1. Surgical Outcome Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia
  2. Sydney School of Public Health, University Of Sydney, Sydney, NSW, Australia
  3. Cancer Epidemiology and Cancer Services Research (CESR), Sydney School of Pubilic Health, University Of Sydney, Sydney, NSW, Australia
  4. Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology , University of Sydney, Sydney, NSW, Australia
  5. Sydney Medical School, Central Clinical School, University of Sydney, Sydney, NSW, Australia
  6. Faculty of Nursing Midwifery and Health, University of Technology, Sydney, NSW, Australia
  7. Division of Hospital Medicine , University of California , San Francisco, California, USA
  8. Discipline of Surgery, University of Sydney, Sydney, NSW, Australia

Background: Patients with upper gastrointestinal cancers have a poor prognosis. As a result, patients and their family caregivers are at risk of experiencing poor quality of life, psychological distress and significant levels of unmet supportive care need.  Caregivers may also experience increased carer burden.

Aim: This study investigated the effectiveness of a structured telephone intervention with carers to improve carers’ and patients’ quality of life.  

Methods: 128 family caregivers of patients starting treatment for a newly diagnosed or recurrent upper gastrointestinal or Dukes D colorectal cancer were randomised (1:1) to the Family CONNECT telephone intervention or usual care. Intervention group participants received four standardised telephone calls in the 10 weeks following patient hospital discharge. Quality of life, carer burden, unmet supportive care need and distress were assessed at 3 and 6 months. Patient reported outcomes were also assessed at these time points.

Results: At baseline, carers in both groups reported clinical levels of distress and mean scores for the Mental Component Summary (MCS) scale of the SF-12 were low (44.56 intervention, 43.20 control).  By 3 months the intervention group showed a greater improvement than the control group in the MCS (diff: 2.14, 95%CI -1.48, 5.75, p=.24) but this was not statistically significant. A decrease in the domain of the carer burden scale (Caregiver Reaction Assessment Scale) relating to impact on finance improved (diff -.0.32, 95%CI-0.7, 0.05, p=.09) in the intervention group but there were no differences between groups in other carer outcomes or patients’ quality of life.   

Conclusions:  This trial was unable to demonstrate substantial or significant benefit of the current intervention to improve carer or patient outcomes.  Given the high levels of baseline distress, interventions that more specifically target caregiver anxiety need to be investigated.