Psychosocial Intervention Promising for Caregivers of Patients Undergoing Stem Cell Transplantation
Key findings
- This randomized, controlled trial by the Mass General Cancer Center examined the feasibility of a six-session psychosocial intervention for caregivers of patients scheduled to undergo allogeneic or autologous hematopoietic stem cell transplantation
- 72% of eligible caregivers enrolled and 69% of caregivers in the intervention group completed all sessions
- Compared with usual care, the intervention was associated with significantly greater improvement in caregivers' quality of life, caregiving burden and anxiety and depression symptoms, as well as their self-efficacy and coping skills
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Families and friends of patients who undergo hematopoietic stem cell transplantation have a prolonged caregiving burden. Yet no available intervention targets their needs before, during and immediately after hematopoietic stem cell transplantation (HCT).
Areej El-Jawahri, MD, hematologist, Jamie M. Jacobs, PhD, clinical staff psychologist, and Jennifer S. Temel, MD, clinical director of Thoracic Oncology, all of Massachusetts General Hospital Cancer Center, and colleagues designed a coping skills intervention, BMT-CARE, that integrates HCT-related education with cognitive–behavioral strategies. In Cancer, they report it was feasible and showed promising preliminary efficacy.
Study Participants and Methods
Between December 2017 and April 2019, the team enrolled 100 primary caregivers for patients undergoing allogeneic or autologous HCT. They were randomly assigned to usual care (one meeting with a social worker, with additional support available) or usual care plus six sessions of BMT-CARE. The intervention included a workbook for in-session and at-home exercises.
Feasibility
The primary endpoint of the study was feasibility, defined as enrollment of ≥60% of eligible caregivers and completion of ≥50% of sessions by 60% of caregivers assigned to BMT-CARE. The study met these endpoints, as 100/138 (72%) of eligible caregivers enrolled and 80% of those in the intervention group attended ≥50% of sessions. 69% of caregivers in the intervention group completed all six sessions.
Outcomes
At day 60 after HCT, all measures studied were significantly better in the BMT-CARE group than the control group: quality of life, caregiving burden, anxiety and depression, self-efficacy (confidence in managing the impact of HCT) and perceived coping skills.
Scalability
About half of the BMT-CARE sessions took place via telephone or videoconference, and diverse professionals delivered the intervention (a psychologist, social worker and psychology fellow). All transplant centers have either psychologists or social workers support patients undergoing HCT and their caregivers, so BMT-CARE has promising potential for scalability.
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