Randomized controlled trial of a home-based palliative approach for people with severe multiple sclerosis
| Autor: | Solari, A., Giordano, A., Patti, F., Grasso, M. G., Confalonieri, P., Palmisano, L., Ponzio, M., Borreani, C., Rosato, R., Veronese, S., Zaratin, P., Battaglia, M. A., Amadeo, R., Lugaresi, A., Martino, G., Pagano, E., Radice, D., Farinotti, M., Ferrari, G., Oliver, D. J., Pucci, E., Tesio, L., Pietrolongo, E., Giuntoli, M., Fittipaldo, A., Cugno, C., Causarano, R., Morino, P., Campanella, A., Mantegazza, R., Tucci, L., Ippoliti, F., Morone, G., Fusco, A., Cascio, V., Cimino, V., Zagari, F., Lopes de Carvalho, M. L., Motta, R., Onofrj, M., Da Col, D., Casale, G. |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty caregivers symptom burden Palliative care Aftercare Severity of Illness Index law.invention Multiple sclerosis 03 medical and health sciences 0302 clinical medicine Quality of life (healthcare) Randomized controlled trial law Activities of Daily Living medicine Humans 030212 general & internal medicine palliative care quality of life randomized controlled trial Aged business.industry Symptom burden Middle Aged medicine.disease Home based Home Care Services Treatment Outcome Neurology Italy Multivariate Analysis Physical therapy Disease Progression Female Neurology (clinical) Homebound Persons business Original Research Papers 030217 neurology & neurosurgery |
| Zdroj: | Multiple Sclerosis (Houndmills, Basingstoke, England) |
| Popis: | 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 (2:1 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|