Hospice Family Caregiver Involvement in Care Plan Meetings: A Mixed-Methods Randomized Controlled Trial.

The primary Caregiver Pain Medicine Questionnaire had validity issues, and four questions were eliminated from later analyses, which may have affected detection of change. The trial was not powered for definitive subgroup conclusions by patient diagnosis. The population was relatively rural and homogeneous. This limits application to more diverse hospice programs. Staff could not be blinded because it was obvious which caregivers attended meetings. Patients with Palliative Performance Scale scores below 30 were excluded, so results may not apply to patients unlikely to survive to attend a meeting. The Generalized Anxiety Disorder measure was added after the first year, so anxiety data are not complete for all participants. Cost-effectiveness analysis was not possible because there were no statistically significant benefits to weigh against costs. Meeting discussions were longer when caregivers participated, which may be problematic in hospice teams that already meet for 3 to 4 hours.

The paper reports that the National Institutes of Health had no role in design, conduct, data collection, management, analysis, interpretation, manuscript preparation, review, approval, or submission. No other funding or conflict statements are given.

Do not conclude that video or phone participation improved pain management or caregiver outcomes. The primary outcome and all secondary outcomes were null, and the significant fatalism subscale and interview pain-control item were not the trial's primary result.