Validating the positive impact of in-hospital lay care-partner support on patient survival in allogeneic BMT: a prospective study

Abstract

This prospective study validates the finding from retrospective research that having an inpatient lay care-partner (CP) is associated with better survival following allogeneic BMT. Compared with patients without a CP (n ¼ 76), patients with a CP (n ¼ 88) have significantly better OS (P ¼ 0.017) and relapse-free survival (RFS) (P ¼ 0.020). Four-year and median survivals were 42% and 36 months among patients with CPs, compared with 26% and 10 months among those without CPs. Four-year survival and median RFS were 39% and 25 months among those with CPs, compared with 23% and 7 months among those without CPs. Further, better survival and RFS were associated with CP visit duration of 43 h per day (P ¼ 0.005 and P ¼ 0.007, respectively) and with CP frequency of visits 475% of inpatient days (P ¼ 0.004 and P ¼ 0.010, respectively). A CP support program should encourage not only presence of a CP but also duration and frequency of CP visits associated with better patient survival.

The Caregiver’s Role Across the Bone Marrow Transplantation Trajectory

“…In a follow-up prospective study, these researchers validated the positive impact of the family caregiver during hospitalization, noting an increase in overall survival and relapse-free survival for BMT recipients who had the support of an in-hospital family caregiver compared with those who did not have this support. 6 Taken together, these findings reaffirm the important role the caregiver has on outcomes across the BMT trajectory.…”

“…Researchers have found that the lack of committed partner/spouse caregivers can both limit the use of outpatient stem cell transplant services 5 and impact survival outcomes for the BMT recipient. 6,7 In a retrospective study, Foster and colleagues 7 found that patients with a partner who stayed with them during their allogeneic transplant were 3 times more likely to be living 1 year after transplant. In a follow-up prospective study, these researchers validated the positive impact of the family caregiver during hospitalization, noting an increase in overall survival and relapse-free survival for BMT recipients who had the support of an in-hospital family caregiver compared with those who did not have this support.…”

Prognostic significance of pre-transplant quality of life in allogeneic hematopoietic cell transplantation recipients

“…1,27 Furthermore, QOL may be a surrogate marker of other sociodemographic factors such as socioeconomic status and care-partner support that may mediate transplantation outcomes. 27,32 Also, patients with lower baseline PWB may have experienced negative impact on their functioning from prior treatment regimens and may be disabled pre-transplant. Hence, baseline QOL, especially physical functioning measures, in conjunction with other measures (for example, HCT-CI) could provide additional information about the patient's ability to tolerate the physiological stresses posed by an allogeneic HCT process ranging from conditioning regimen toxicities to post-transplant events such as GvHD.…”

Cardiometabolic risk factors and health behaviors in family caregivers

“…In the realm of cancer care, HSCT is one the most intense cancer treatments, potentially leading to serious and sometimes life-threatening treatment toxicities, as well as long-term health issues from chronic graft versus host disease [12]. Accordingly, transplant centers require transplant patients to have a caregiver at all times during the immediate post-transplant recovery period to provide physical and emotional support to the patient and to assist in the assessment and management of treatment-related symptoms [13]. While caregiving can be a rich and rewarding experience [14], individuals providing care to a friend or family member undergoing HSCT experience a multitude of competing demands that can lead to disruption in their daily lives and profound stress [15–17].…”