The effect of the Carer Support Needs Assessment Tool intervention (CSNAT-I) in the Danish specialised palliative care setting: a stepped wedge cluster randomised controlled trial

Line Lund, Lone Ross, Morten Aagaard Petersen, Annemette Blach, Elizabeth Rosted, Georg Bollig, Gitte Irene Juhl, Hanne Fahrholt, Helen Winther, Louise Laursen, Marianne Hasse, Signe Weensgaard, Mai-Britt Guldin, Gail Ewing, Gunn Grande, Mogens Groenvold

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The Carer Support Needs Assessment Tool intervention (CSNAT-I) has been shown to improve end-of-life care support for informal caregivers. This study investigated the impact of the CSNAT-I on caregivers of patients recently enrolled in specialised palliative care (SPC) at home in Denmark. Methods: A stepped-wedge cluster randomised controlled trial with nine clusters (i.e., SPC teams). Outcome measures were collected using caregiver questionnaires at baseline (T0) and two (T1) and four (T2) weeks follow-up. ClinicalTrials.gov ID: NCT03466580. Results: A total of 437 caregivers were enrolled (control group, n=255; intervention group, n=182). No intervention effect was found on the primary outcome, caregiver strain at T1 (p = 0.1865). However, positive effects were found at T1 and T2 on attention to caregivers’ wellbeing (p < 0.0001), quality of information and communication (p < 0.0001), amount of information (T1: p = 0.0002; T2: p < 0.0001), involvement (T1: p = 0.0045; T2: p < 0.0001), talking about greatest burdens (p < 0.0001) and assistance in managing greatest burdens (p < 0.0001). The effect sizes of these differences were medium or large and seemed to increase from T1 to T2. At T1, positive effects were found on distress (p = 0.0178) and home care responsibility (p = 0.0024). No effect was found on the remaining outcomes. Conclusion: Although no effect was found on caregiver strain, the CSNAT-I showed positive effects on caregiver distress, home care responsibility and key outcomes regarding caregivers’ experience of the interaction with health care professionals.
Original languageEnglish
JournalBMJ Supportive & Palliative Care
Publication statusAccepted/In press - 24 Sept 2020

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