Randomized controlled trial of a home-based palliative approach for people with severe multiple sclerosis.
Mult Scler
; 24(5): 663-674, 2018 04.
Article
em En
| MEDLINE
| ID: mdl-28381133
ABSTRACT
BACKGROUND:
Evidence on the efficacy of palliative care in persons with severe multiple sclerosis (MS) is scarce.OBJECTIVE:
To assess the efficacy of a home-based palliative approach (HPA) for adults with severe MS and their carers.METHODS:
Adults with severe MS-carer dyads were assigned (21 ratio) to either HPA or usual care (UC). At each center, a multi-professional team delivered the 6-month intervention. A blind examiner assessed dyads at baseline, 3 months, and 6 months. Primary outcome measures were Palliative care Outcome Scale-Symptoms-MS (POS-S-MS) and Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW, not assessed in severely cognitively compromised patients).RESULTS:
Of 78 dyads randomized, 76 (50 HPA, 26 UC) were analyzed. Symptom burden (POS-S-MS) significantly reduced in HPA group compared to UC ( p = 0.047). Effect size was 0.20 at 3 months and 0.32 at 6 months, and statistical significance was borderline in per-protocol analysis ( p = 0.062). Changes in SEIQoL-DW index did not differ in the two groups, as changes in secondary patient and carer outcomes.CONCLUSION:
HPA slightly reduced symptoms burden. We found no evidence of HPA efficacy on patient quality of life and on secondary outcomes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidados Paliativos
/
Serviços de Assistência Domiciliar
/
Esclerose Múltipla
Tipo de estudo:
Clinical_trials
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article