Control Conditions That Are Neither Usual Care Nor No Treatment in Randomized Trials of Psychoeducational Palliative Care Interventions: A Systematic Review.
Hyejin Kim, Eliza M Park, Carrie Henry and 2 others
PMID 30343586WHAT IT FOUND
In palliative psychoeducation trials that used controls other than usual care, many control groups received attention or active materials, and reports often omitted who delivered them and fidelity data.
Key findings
01The review screened 70 full-text articles and included 9 trial reports.
02Of 8 trials with control conditions that were attention controls or had some attention-control aspects, 4 used attention controls designed to match the active intervention in amount and intensity of attention, setting, and interaction mode.
03Control condition descriptions were substantially shorter than active intervention descriptions, none described qualifications or training required to deliver the control condition, and no report included control group fidelity monitoring data.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 9 trial reports, so the patterns may not represent all psychoeducational palliative care trials. Most included trials tested advance care planning, goals of care in advanced dementia, or communication and decision-making, and pain and symptom management trials were not included. There is no agreed gold standard for constructing attention controls, so the review could not empirically determine whether a control was adequate. The review excluded comparative effectiveness trials and studies of health-care providers or trainees, so it does not address those designs.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not read this review as evidence that psychoeducational palliative care interventions work better than usual care. It examined how control conditions were designed and reported, not patient outcomes.