Impact of Caregiver and Patient Age on Efficacy of Caregiver Interventions in Advanced Cancer: A Meta-Regression.

Abstract

It has been shown that interventions to support caregivers of patients with advanced cancer improve caregiver wellbeing, but the possible additional influence of patient and caregiver age is unknown. We measured the impact of patient and caregiver age on the efficacy of caregiver interventions. We included all studies from a recent meta-analysis of randomized controlled trials of caregiver support interventions for adult caregivers of adults with advanced cancer that reported on outcomes of quality of life (QOL), anxiety, or depression. Random-effects meta regression was performed on each outcome for continuous variables of: 1) mean patient age, 2) mean caregiver age, and 3) mean age difference between mean age of patients and caregivers. Among study sets demonstrating statistically significant associations, we performed sensitivity analyses excluding influential outliers. Twenty-four studies reporting on 23 trials involving 3306 caregivers were included in this meta-regression. Interventions were associated with improved QOL, anxiety and depression. In studies with older mean patient age, interventions had a greater impact on QOL (P = 0.04). In studies with younger mean caregiver age, interventions had a greater impact on depression (P = 0.02). In studies with a larger patient-caregiver age difference, interventions had a greater impact on anxiety (P = 0.01), but this effect did not prevail on sensitivity analysis (P = 0.52). Age of patients with advanced cancer and their caregivers may influence the efficacy of caregiver support interventions, and should be taken into account when designing these interventions and interpreting their effect.