Enhancing communication between oncology care providers and patient caregivers during hospice

Background When patients enroll in hospice, they and their close family and friends (ie, caregivers) often report feeling a sense of abandonment because of the break in routine communication with their oncology clinicians (physicians, nurse practitioners [NP], registered nurses [RN], and/or physician assistants [PA]). Objective To assess the feasibility of an intervention to facilitate communication between oncology clinicians and caregivers of patients in hospice care. Methods Caregivers of patients with cancer who enrolled in home hospice were eligible to participate. The intervention consisted of supportive phone calls from their oncology clinicians, an optional clinic visit, and a bereavement call. The primary outcome was feasibility, defined as >70% of caregivers receiving >50% of phone calls and >70% of caregivers completing >50% of questionnaires. We also assessed caregiver satisfaction with the supportive intervention, stress, decision regret, and perceptions of end-of-life care. Results Of 38 eligible caregivers, 6 declined participation, 7 could not be reached, and 25 (81%) enrolled in the study. Of those, 22 caregivers were evaluable after 2 patients died before the intervention began and 1 caregiver withdrew. Oncology clinicians completed 164 of the expected 180 calls (91%) to caregivers. The majority of the calls were made by the RN or NP. Caregivers completed 78 of the expected 99 (79%) questionnaires. All of the caregivers received >50% of scheduled phone calls, and 73% completed >50% of the questionnaires. During exit interviews, caregivers reported satisfaction with the intervention. Limitations Single-institution, small sample size Conclusions This intervention proved feasible because caregivers received the majority of planned phone calls from oncology clinicians, completed the majority of study assessments, and reported satisfaction with the intervention. A randomized trial to evaluate the impact on caregiver outcomes is warranted.