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Randomized controlled trial of a home-based palliative approach for people with severe multiple sclerosis.


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

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Publications

Randomized controlled trial of a home-based palliative approach for people with severe multiple sclerosis.

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]

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