Journal
MULTIPLE SCLEROSIS JOURNAL
Volume 24, Issue 5, Pages 663-674Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1352458517704078
Keywords
Multiple sclerosis; palliative care; randomized controlled trial; quality of life; symptom burden; caregivers
Categories
Funding
- Fondazione Italiana Sclerosi Multipla (FISM) [2014/S/1]
Ask authors/readers for more resources
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, 3months, and 6months. 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 (50HPA, 26UC) were analyzed. Symptom burden (POS-S-MS) significantly reduced in HPA group compared to UC (p=0.047). Effect size was 0.20 at 3months and 0.32 at 6months, 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.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available