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ABSTRACT: 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.
SUBMITTER: Solari A
PROVIDER: S-EPMC5946675 | biostudies-literature | 2018 Apr
REPOSITORIES: biostudies-literature
Solari Alessandra A Giordano Andrea A Patti Francesco F Grasso Maria Grazia MG Confalonieri Paolo P Palmisano Lucia L Ponzio Michela M Borreani Claudia C Rosato Rosalba R Veronese Simone S Zaratin Paola P Battaglia Mario Alberto MA
Multiple sclerosis (Houndmills, Basingstoke, England) 20170406 5
<h4>Background</h4>Evidence on the efficacy of palliative care in persons with severe multiple sclerosis (MS) is scarce.<h4>Objective</h4>To assess the efficacy of a home-based palliative approach (HPA) for adults with severe MS and their carers.<h4>Methods</h4>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 month ...[more]