Enhancing the experience of carers in the chemotherapy outpatient setting: an exploratory randomised controlled trial to test impact, acceptability and feasibility of a complex intervention co-designed by carers and staff

• Published in: Supportive care in cancer 2015-10, Vol.23 (10), p.3069-3080
• Main Authors: Tsianakas, V., Robert, G., Richardson, A., Verity, R., Oakley, C., Murrells, T., Flynn, M., Ream, E.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Ambulatory care facilities; Cancer; Caregivers - psychology; Chemotherapy; Female; Health Personnel; Humans; Intervention; Male; Medical personnel; Medicine; Medicine & Public Health; Middle Aged; Nursing; Nursing Research; Oncology; Original Article; Outpatient care facilities; Outpatients; Pain Medicine; Rehabilitation Medicine; Surveys and Questionnaires
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-015-2677-x

Purpose Supporting someone through chemotherapy can be emotionally and physically demanding. However, research has yet to establish the type of support carers require or the best way to provide this. This study tested the feasibility and acceptability of a complex intervention for carers that was co-designed by staff and carers of patients starting chemotherapy. Methods Forty-seven carers were recruited, randomised between the intervention ( n  = 24) and control ( n  = 23) groups. A questionnaire was completed pre- and post-intervention measuring knowledge of chemotherapy and its side effects, experience of care, satisfaction with outpatient services, coping and emotional wellbeing. The intervention process was evaluated by carers and healthcare professionals (HCPs) in focus groups. Results Recruitment to the study was unproblematic and attrition from it was low, suggesting the intervention and study processes were acceptable to patients and carers. Carers in receipt of the ‘Take Care’ intervention reported statistically significantly better understanding of symptoms and side effects and their information needs being more frequently met than carers in the control. Confidence in coping improved between baseline and follow-up for the intervention group and declined for the control although differences were insufficient to achieve statistical significance. There was no significant difference between the two groups’ emotional wellbeing. HCP and carer focus groups confirmed the feasibility and acceptability of the intervention. Conclusions The ‘Take Care’ intervention proved acceptable to carers and HCPs and demonstrates considerable promise and utility in practice. Study findings support the conduct of a fully powered RCT to determine the intervention’s effectiveness and cost-effectiveness.