Shaw, J.M., Young, J.M., Butow, P.N., Badgery-Parker, T., Durcinoska, I., Harrison, J.D., . . . Solomon, M.J. (2015). Improving psychosocial outcomes for caregivers of people with poor prognosis gastrointestinal cancers: A randomized controlled trial (Family Connect). Supportive Care in Cancer, 24, 585–595. 

To assess the effectiveness of an intervention using structured telephone interventions for the caregivers of patients diagnosed with gastrointestinal cancer that had a poor prognosis to improve psychosocial outcomes of the patient and caregiver

This intervention was a randomized, controlled trial in which caregivers were assigned to either the family connect (FC) telephone intervention or usual care. The FC group received four standardized telephone calls in the 10 weeks after patient hospital discharge. The caregivers’ quality of life, caregiver burden, unmet supportive needs, and distress were assessed at three and six months.

• N = 128 pairs  
• AVERAGE AGE = 55.7 years (intervention); 52.7 years (control)
• MALES: 61%, FEMALES: 39%
• KEY DISEASE CHARACTERISTICS: Patients with all cancers found within area of the gastrointestinal system and their caregivers were included.
• OTHER KEY SAMPLE CHARACTERISTICS: Most were English-speaking, and all received some prior form of cancer treatment.

• SITE: Four metropolitan hospitals in Sydney, Australia
• SETTING TYPE: Initial, hospital, follow up, telephone
• LOCATION: Sydney, Australia

• PHASE OF CARE: Newly diagnosed or recurrent primary upper gastrointestinal cancer, metastatic liver disease, or stage 4 colorectal cancer
• APPLICATIONS: Palliative care 

This study was a parallel-randomized trial with a 1:1 group allocation.

• Quality of Life (QOL) scale Short Form 12 (SF-12) v2
• Caregiver Reaction Assessment (CRA)
• Functional Assessment of Cancer Therapy–General (FACT-G)
• Supportive Care Needs Survey (SCNS-34) patient version
• Single-item distress thermometer

Caregiver QOL scores were similar in both groups. The group that was randomized to receive the intervention reported a greater sense of social support and reduced worry about finances, and they also had fewer rehospitalization and emergency department visits.

This intervention did not demonstrate significant improvements in quality of life or sense of well-being for the caregivers. There were some trends observed through data analysis, which warranted the continued development of meaningful, telephone-based, caregiver-focused supportive care interventions.

• Risk of bias (no blinding)
• Intervention expensive, impractical, or training needs
• Subject withdrawals ≥ 10%
• Other limitations/explanation: The high level of withdrawals prior to randomization (20% of caregivers and 32% of patients) may have resulted from need for both patients and caregivers to agree to participate in the study.

This study did demonstrate the potential to improve patient and caregiver QOL. Future nursing research should focus on continuing to educate caregivers with strategies to identify and address patient care needs, which can ultimately reduce the overall cost to healthcare systems.