Effect of early palliative care on caregivers of adult patients with chronic diseases: A systematic review and meta-analysis of randomized controlled trials

The aim of this research was to examine the effects of early palliative care on individuals who provide care for adult patients with chronic diseases. From the earliest date until November ۱, ۲۰۲۲, the databases of Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database were thoroughly searched using purpose-related keywords. To rate the caliber of randomized control trials and quasi-experimental research, the Joanna Briggs Institute (JBI) critical evaluation checklist was utilized. A total of ۸۰۰ patients with chronic disease were included in five studies. This study demonstrated that early palliative care treatments had a similar impact on caregivers' quality of life (QoL) as routine care and delayed palliative care interventions (ES: -۰.۰۱, ۹۵%CI: -۰.۲۰ to ۰.۱۷, Z=۰.۱۵, I۲:۰.۰%, P=۰.۸۸). As compared to the normal care group, the early care group's caregivers' depression was modestly reduced by the intervention, but this difference was not statistically significant (ES: -۰.۰۶, ۹۵%CI: -۰.۳۶ to ۰.۲۳, Z=۰.۴۳, I۲:۰.۰%, P=۰.۶۷). Early palliative care reduced caregiver anxiety, however, the difference between the intervention group and the group receiving standard care was not statistically significant (ES: -۰.۲۵, ۹۵%CI: -۰.۶۴ to ۰.۱۵, Z=۱.۲۳, I۲:۰.۰%, P=۰.۲۲). Caregivers' burdens were reported based on three dimensions demand, stress, and objective. Results found the intervention caused a non-significant decrease in the demand dimension (WMD: -۰.۴۸, ۹۵% CI: -۱.۱۳ to ۰.۱۷, Z=۱.۴۴, I۲:۰.۰%, P=۰.۱۵) and a significant decrease in the stress dimension (WMD: -۰.۶۵, ۹۵% CI: -۱.۲۶ to -۰.۰۴, Z=۲.۰۹, I۲:۰.۰%, P=۰.۰۴), in the intervention group compared to the routine care. In contrast, the intervention did not affect the objective dimension (WMD: ۰.۳۰, ۹۵%CI: -۰.۴۸ to ۱.۰۸, Z=۰.۷۶, I۲:۰.۰%, P=۰.۴۵) in the intervention group than in routine care. Therefore, it is suggested that more interventional studies be conducted in this area in the future.

Keywords:

Palliative Care , Chronic Disease , Caregivers , Caregiver Burden , Meta-analysis.