Videoconference Intervention for Distance Caregivers of Patients With Cancer: A Randomized Controlled Trial

Abstract

Purpose: Approximately 20% of caregivers (CGs) live > 1 hour away from the patient and are considered distance caregivers (DCGs) who often report higher distress and anxiety than local CGs. The purpose of this study was to test the effectiveness of an intervention aimed at reducing anxiety and distress in DCGs of patients with cancer.

Methods: This randomized controlled trial enrolled DCGs of patients with all cancer types who were being seen monthly by oncologists in outpatient clinics. There were three arms of the intervention delivered over a 4-month period: arm 1 (a) received 4 monthly videoconference-tailored coaching sessions with an advanced practice nurse or social worker focused on information and support, (b) participated in patient's appointments with the oncologist via videoconference over the 4-month study period, and (c) had access to a website designed for DCGs. Arm 2 did not receive the coaching sessions but received the other two components, and arm 3 received access to the DCG website only.

Results: There were 302 DCGs who provided pre- and postintervention data. There were significant anxiety by group (P = .028 and r = 0.16) and distress by group interactions (P = .014 and r = 0.17). Arm 1 had the greatest percentage of DCGs who demonstrated improvement in anxiety (18.6%) and distress (25.2%).

Conclusion: Coaching and use of videoconference technology (to join the DCG into the patient-oncologist office visit) were effective in reducing both anxiety and distress for DCGs. These components could be considered for local CGs who-with COVID-19-are unable to accompany the patient to oncologist visits.

Figures

Fig 1.

CONSORT diagram.

Fig 2.

Distress and anxiety outcomes. (A) Change in distance caregiver (DCG) NCCN distress score from preintervention to postintervention (4-month intervention period) between arm 1 group (tailored coaching plus videoconference meetings with the DCG, patient, and oncologist plus DCG specific website), arm 2 group (videoconference meetings plus DCG-specific website), and arm 3 group (DCG-specific website). Distress scores ≥ 4 mark threshold for referral for follow-up evaluation. (B) Change in DCG anxiety t-score (Patient-Reported Outcomes Measurement Information System-Anxiety SF-4) from preintervention to postintervention between arm 1 group, arm 2 group, and arm 3 group. Anxiety t-scores > 55 mark threshold for anxiety above normal. Y-axis for anxiety t-scores is truncated for clarity. NCCN, National Comprehensive Cancer Network.