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Palliative Care Coaching for Family Caregivers of Patients With Advanced Cancer: A Randomized Clinical Trial
J Nicholas Odom1,2,3, Andres Azuero1, Richard A Taylor2,3,4
1School of Nursing, University of Alabama at Birmingham.
JAMA Network Open
|June 23, 2026
Summary
A telehealth intervention for African American and rural family caregivers of advanced cancer patients showed no significant improvements in caregiver or patient outcomes at 24 weeks. Exploratory analysis suggested potential benefits for caregiver anxiety and patient quality of life.
Area of Science:
- Oncology
- Palliative Care
- Telehealth Interventions
- Caregiver Support
Background:
- African American and rural family caregivers of advanced cancer patients face significant challenges with limited resources.
- Early palliative care interventions are crucial for supporting these caregivers and their patients.
Purpose of the Study:
- To evaluate the effectiveness of a lay coach-led telehealth intervention (ENABLE Cornerstone) for African American and rural family caregivers of advanced cancer patients.
- To assess the impact on caregiver distress, anxiety, depressive symptoms, burden, and quality of life at 24 weeks.
Main Methods:
- A single-blind randomized clinical trial involving 222 family caregivers and 165 patients.
- Intervention group received weekly telehealth sessions with a lay coach; control group received usual care.
- Outcomes measured using Hospital Anxiety and Depression Scale (HADS) and Patient-Reported Outcomes Measurement Information System (PROMIS).
Main Results:
- No statistically significant differences were observed between groups for primary outcomes (caregiver anxiety and depressive symptoms).
- Secondary outcomes including caregiver burden and patient quality of life also showed no significant between-group differences at 24 weeks.
- Exploratory analysis indicated potential improvements in caregiver anxiety and patient mental health quality of life among distressed caregivers.
Conclusions:
- The ENABLE Cornerstone telehealth intervention did not demonstrate significant improvements in overall caregiver and patient outcomes at 24 weeks.
- Further research may explore targeted interventions for specific caregiver needs, such as anxiety reduction.
- The study highlights the need for continued support and resource development for this vulnerable caregiver population.
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