Psychosocial support for informal caregivers of people living with cancer

Charlene Treanor and colleagues recently published their review. Read the plain language statement below or see the full review on the Cochrane Library.

Background

Increasingly, people who are not health professionals provide care for a partner, family member or friend affected by cancer, which can have negative effects on their health and wellbeing. Psychosocial interventions that comprise psychological or social support and involve direct interaction between a healthcare professional and caregivers (or caregiverpatient pairs) may help to address the negative health effects for caregivers.

Review question

What is the effectiveness of psychosocial interventions compared to usual care for informal caregivers of people living with cancer on a range of outcomes related to health and wellbeing?

Results

We found19 trials that compared psychosocial interventions with usual care, in studies that included almost four thousand participants. Studies included caregivers of people affected by different cancers across all stages of the disease. There were differences in intervention makeup. Intervention examples include providing information and/or teaching caregivers (or caregiverpatient pairs) coping, communication or problemsolving skills to manage symptoms or improve relationships. Interventions were delivered by nurses, psychologists or other professionals on an outpatient basis or at home via telephone.

There may be a minimal benefit for caregiver qualityoflife immediately after the intervention, but this may not last. Psychosocial interventions may have little to no effect on quality of life for patients six to 12 months postintervention, but we are uncertain whether or not interventions improve quality of life for patients immediately postintervention.

Psychosocial interventions may have little to no effect on caregiver depression, anxiety, distress and physical health and patient anxiety and distress at any time after the intervention, or on patient depression immediately and patient physical health six to 12 months postintervention. Psychosocial interventions probably have little to no effect on patient physical health immediately postintervention or patient depression three to six months postintervention.

Three studies reported adverse effects including increased distress and sexual functionrelated distress and lower relationship satisfaction levels for carers, increased distress levels for patients, and intervention content that was seen as inappropriate for some participants. No studies looked at costeffectiveness or intervention satisfaction for caregivers or patients. Because the quality of evidence was low generally, findings must be treated with caution.

Conclusion

Psychosocial interventions do not impact to a clinically meaningful degree outcomes for caregivers irrespective of patient cancer stage or type. Perhaps, other outcomes (e.g. relationship quality) or other psychosocial interventions (e.g. meditation) may be more helpful for caregivers. Interventions should be subjected to better conducted trials. Intervention development should involve caregivers and pay particular attention to individual personal needs.