Cancer Caregivers Experienced Decreases in Stress, Anxiety When Using Video Technology to Supplement Care

A videoconference intervention system significantly reduced anxiety and stress levels in people who are caregivers for patients with cancer and live more than one hour away from the patient, according to data from a randomized controlled trial presented during a 2020 ASCO Virtual Scientific Program press briefing.

“Distance caregivers should know that the full intervention of coaching sessions from a professional, plus videoconference office visits, plus the website had the greatest effect on improving their stress and anxiety,” lead study author Dr. Sara L. Douglas, The Gertrude Perkins Oliva Professor in Oncology Nursing at the Frances Payne Bolton School of Nursing in Cleveland, said during a pre-recorded presentation.

Douglas noted that people who provide care for patients with cancer are a crucial part of the care team. However, as Douglas noted, caregivers who live more than one hour away, considered distance caregivers, rarely receive recognition for their efforts.

Additionally, high rates of anxiety and stress have been found to have a negative impact on both the health of the caregiver, as well as their ability to provide high-quality care for the patient, according to Douglas.

As a result, researchers aimed to assess the effectiveness of an intervention aimed at reducing anxiety and distress in distance caregivers who support patients with cancer. A total of 441 caregivers were randomized to three intervention arms:

• Caregivers in the first arm had access to an advanced practice nurse of social worker through videoconference once a month for four months, participated in patient-oncologist visits via videoconference and had access to a website with information specifically designed for distance caregivers.
• The second arm had access to the patient-oncologist visits via videoconference and the website.
• The third arm, referred to as the control arm by researchers, only had access to the website.

Of the total group, 311 caregivers completed a questionnaire before the start of the study as well as at the end of the four-month intervention to assess any changes in their distress and anxiety levels.

According to measurements using the National Comprehensive Cancer Network Distress Thermometer, 24.8% of caregivers in the first arm experienced an improvement in their distress score vs. 19.8% in the second arm and 18% in the third arm.

Using the Patient-Reported Outcomes Measurement Information System, 19.2% of caregivers within the first arm experienced an improvement in anxiety score vs. 17.3% in the second arm and 13.1% in the third arm.

Physicians, patients and caregivers were also asked to score their satisfaction with the videoconference office visits using a scale of 1-10. Physicians from the study reported a score of 8, patients reported a score of 9.1 and caregivers reported a score of 9.3.

“Anecdotally, what a lot of the oncologists who participated in the study said was that they really liked video conference vs. the phone,” Douglas said in a virtual press briefing. “They felt that they were able to show scans by having the video conference component, they were able to actually meet the distance caregiver face-to-face, they were able to pick up on non-verbal cues and they felt that it enhanced communication.”

Douglas emphasized that patients should know that while the videoconference office visits were beneficial in helping caregivers feel less stressed, it also helped the patient feel more supported during the visit. And although Douglas noted that the first arm had the best results with the incorporation of all intervention forms, she acknowledged that isn’t always feasible.

“While the full intervention yielded the best results for distance caregivers, we recognize that not all healthcare systems have the resources to provide individualized coaching sessions to distance caregivers,” she said. “Therefore, it is worth noting that video conference office visits alone were found to be of some benefit in improving stress and anxiety in this group of cancer caregivers.”

These results, according to Dr. Cardinale B. Smith, chief quality officer of cancer services at Mount Sinai Health System, are important for the wellbeing of cancer caregivers.

“Caregivers play an important role in cancer care delivery and literature demonstrates that they often have increased anxiety, depression and poorer health outcomes when caring for a loved one with serious illness,” Smith, who was not affiliated with the study, said to CURE® in statement. “The intervention described in this abstract is important in that it provides clear and concrete activities — videoconference and coaching — caregivers can participate in to decrease anxiety and stress.”

Douglas also highlighted how these results hold even more importance now, as patients are currently prohibited from attending doctor’s visits with a caregiver to stop the spread of the new coronavirus.

“In this time of COVID-19 and distancing, this intervention has the potential to benefit not only the true distance caregivers but other caregivers who may no longer be able to be with their loved one with cancer for office visits and treatments due to institutional or health restrictions,” Douglas concluded.