Caregiver outcomes in nurse-led telephonic versus specialty palliative care for the seriously ill.

OBJECTIVES: Caregivers of persons living with serious illness suffer from stress, anxiety and depression. We aim to assess caregiver strain, quality of life (QOL) and bereavement of caregivers of patients enrolled in Emergency Medicine Palliative Care Access (EMPallA), a multicentre randomised controlled trial. METHODS: Patients and caregivers were recruited between April 2018 and June 2022 in 18 emergency departments in the USA. Caregiver inclusion criteria were 18 years or older, spoke English or Spanish, and were primary caregivers of enrolled patients. We randomised patient-caregiver dyads at the patient level. Caregivers were encouraged to accompany patients in both care models (nurse-led telephonic palliative care or specialty palliative care), although there was no specific caregiver intervention. We performed mixed effects linear regression models to assess change in caregiver strain and QOL at 6 months and bereavement. RESULTS: Among 323 caregivers, mean age was 56.9 (SD 14.2), 221 (68%) were female and 77 (24%) were Black. The analysis did not reveal any differences in caregiver strain, QOL, and bereavement between the two care models. The estimated difference in average change in strain scores between groups was -1.6 points (95% CI: -3.4 to 0.3), average change in caregiver physical QOL was 0.5 (95% CI: -0.9 to 1.8), average change in caregiver mental health QOL was 1.8 (95% CI: -0.1 to 3.6) and average change in bereavement scores was 1.8 (95% CI: -2.9 to 6.6). CONCLUSIONS: The study did not demonstrate that nurse-led telephonic care improved caregiver strain, QOL or bereavement outcomes compared with traditional outpatient palliative care. TRIAL REGISTRATION NUMBER: NCT03325985.