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Dr Alessandra Solari: Secondary analysis of a randomized controlled trial on palliative care for severe MS and their caregivers
In this interview, Dr Solari discusses results from a secondary analysis of a randomized controlled trial on palliative care in patients with severe MS and their caregivers. Endpoints included health-related quality of life, caregiver burden and psychological wellbeing. Seventy-eight patients and caregivers were evaluated and MS patients were bed-ridden.
Subjects were evaluated using the short-form health survey, SF-36. As expected, caregivers were substantially impacted and scored low on health-related quality of life and high on pathological anxiety (in over 70% of subjects) and depression levels (in over 40% of subjects). Over 40% of caregivers experienced both anxiety and depression.
In contrast, the Zarit Burden Interview (ZBI) scale showed only a moderate impact on the caregiver’s psychological wellbeing. This discrepancy could have resulted from the often decades-long caring time leading to an inability to disentangle a caregiver’s needs from those of the person with MS. Also, the ZBI scale was designed for dementia, so may not be entirely relevant in MS cases. Dr Solari discusses a number of factors that contribute to patient burden and reinforces the importance of evaluating the caregiver’s burden and mental health.
The next phase is to evaluate the effectiveness of a palliative care approach; the study has been completed and analysis is underway.
The interview was recorded at the annual ECTRIMS meeting from 14-17 September 2016 in London, United Kingdom.
Dr Alessandra Solari, Neurologist, Istituto Neurologico Carlo Besta, Milan, Italy.