Do family meetings for hospitalised palliative care patients improve outcomes and reduce health care costs? A cluster randomised trial

Background: Family meetings facilitate the exploration of issues and goals of care however, there has been minimal research to determine the benefits and cost implications. Aims: To determine: (1) if family caregivers of hospitalised patients referred to palliative care who receive a structured fami...

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Bibliographic Details
Published in:Palliative medicine 2021-01, Vol.35 (1), p.188-199
Main Authors: Hudson, Peter, Girgis, Afaf, Thomas, Kristina, Philip, Jennifer, Currow, David C, Mitchell, Geoffrey, Parker, Deborah, Liew, Danny, Brand, Caroline, Le, Brian, Moran, Juli
Format: Article
Language:English
Subjects:
Caregivers
Caregiving
Clinical outcomes
Clinical research
Clinical trials
End of life decisions
Evaluation
Health care expenditures
Health status
Hospice care
Hospitalization
Intervention
Meetings
Opportunity costs
Palliative care
Psychological distress
Quality of life
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Summary:Background: Family meetings facilitate the exploration of issues and goals of care however, there has been minimal research to determine the benefits and cost implications. Aims: To determine: (1) if family caregivers of hospitalised patients referred to palliative care who receive a structured family meeting report lower psychological distress (primary outcome), fewer unmet needs, improved quality of life; feel more prepared for the caregiving role; and receive better quality of end-of-life care; (2) if outcomes vary dependant upon site of care and; (3) the cost-benefit of implementing meetings into routine practice. Design: Pragmatic cluster randomised trial involving palliative care patients and their primary family caregivers at three Australian hospitals. Participants completed measures upon admission (Time 1); 10 days later (Time 2) and two months after the patient died (Time 3). Regression analyses, health utilisation and process evaluation were conducted. Results: 297 dyads recruited; control (n = 153) and intervention (n = 144). The intervention group demonstrated significantly lower psychological distress (Diff: –1.68, p 
ISSN:0269-2163
1477-030X
DOI:10.1177/0269216320967282