Do family meetings for hospitalised palliative care patients improve outcomes and reduce health care costs? A cluster randomised trial.
Palliat Med
; 35(1): 188-199, 2021 01.
Article
en En
| MEDLINE
| ID: mdl-33135552
ABSTRACT
BACKGROUND:
Family meetings facilitate the exploration of issues and goals of care however, there has been minimal research to determine the benefits and cost implications.AIMS:
To determine (1) if family caregivers of hospitalised patients referred to palliative care who receive a structured family meeting report lower psychological distress (primary outcome), fewer unmet needs, improved quality of life; feel more prepared for the caregiving role; and receive better quality of end-of-life care; (2) if outcomes vary dependant upon site of care and; (3) the cost-benefit of implementing meetings into routine practice.DESIGN:
Pragmatic cluster randomised trial involving palliative care patients and their primary family caregivers at three Australian hospitals. Participants completed measures upon admission (Time 1); 10 days later (Time 2) and two months after the patient died (Time 3). Regression analyses, health utilisation and process evaluation were conducted.RESULTS:
297 dyads recruited; control (n = 153) and intervention (n = 144). The intervention group demonstrated significantly lower psychological distress (Diff -1.68, p < 0.01) and higher preparedness (Diff 3.48, p = 0.001) at Time 2. No differences were identified based on quality of end of life care or health utilisation measures.CONCLUSIONS:
Family meetings may be helpful in reducing family caregiver distress and enhancing their preparedness for the caregiving role and it appears they may be conducted without increased hospital health utilisation impacts; although opportunity costs need to be considered in order to routinely offer these as a standardised intervention. Additional health economic examination is also advocated to comprehensively understand the cost-benefit implications. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12615000200583.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Cuidados Paliativos
/
Calidad de Vida
Tipo de estudio:
Clinical_trials
/
Health_economic_evaluation
Límite:
Humans
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Palliat Med
Asunto de la revista:
SERVICOS DE SAUDE
Año:
2021
Tipo del documento:
Article
País de afiliación:
Australia