25. General health: home palliative care versus usual care.
| Study | Measure | Analysis | Follow‐up | Significance and direction | Details |
|
Jordhøy 2000 Norway (high quality) |
EORTC‐QLQ‐C30 global health scale (2 items) transformed score: from 0 to 100, higher scores equal better global health; patient report |
Forwards from enrolment |
1 month | n.s.a SAUC intervention ‐1.1 vs. SAUC control 1.1 P value = 0.48 |
Intervention (n = 153): M 49 Control (n = 116): M 48 |
| 2 months | Intervention (n = 108): M 51 Control (n = 93): M 49 |
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| 4 months | Intervention (n = 71): M 50 Control (n = 65): M 53 |
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| 6 months | Differences and statistical significance not stated | Intervention (n = 56): M 55 Control (n = 52): M 52 |
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|
McCorkle 1989 US |
General Health Rating index (22 items) score: from 22 to 110, lower scores equal better health perceptions; patient report |
Forwards from enrolment |
6 weeks | Favours intervention F = 4.06 P value = 0.05 b |
Adjusted estimates Intervention: M 61.11 Control1 (home cancer care): M 61.26 Control2 (usual outpatient care): M 59.05 |
| 12 weeks | Adjusted estimates Intervention: M 59.53 Control1 (home cancer care): M 60.14 Control2 (usual outpatient care): M 59.66 |
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| 18 weeks | Adjusted estimates Intervention: M 57.04 Control1 (home cancer care): M 57.84 Control2 (usual outpatient care): M 60.64 |
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|
Aiken 2006 US |
SF‐36 general health subscale transformed score: from 0 to 100, higher scores equal better general health, negative slope equal reduction; patient report |
F from enrolment |
9 months | Favours intervention for both COPD and CHFc slope: z 2.16, P value < 0.05 intercept at 9 months: z 2.52; P value < 0.05; g 0.47 |
Growth modelling analysis (separate for COPD and CHF patients) Slope declined for controls while health remained stable for intervention patients, and the intervention intercept exceeded that of controls at 9 months COPD slope: 0.54 intervention vs. ‐1.67 control CHF slope: 0.16 intervention vs. ‐0.17 control |
CHF: congestive heart failure; COPD: chronic obstructive pulmonary disease; EORTC QLQ‐C30: European Organisation for Research and Treatment of Cancer Quality of Life questionnaire; M: mean; n.s.: non‐significant; SAUC: standardised area under the curve. aThe authors calculated mean changes from baseline at one to four months after enrolment by dividing the area under the curve scores by time; differences between groups were tested by bootstrap estimation to fit regression models allowing for clustering and predictive factors. bThe authors used repeated measures analysis and analysis of variance; analysis included 78 patients who completed the three follow‐up interviews (i.e. up to 18 weeks after enrolment); adjusted means were used due to baseline differences despite randomisation; graphs showed that patients receiving the intervention and the control1 (i.e. those receiving cancer home care) experienced better health perceptions over time while control2 patients (i.e. those receiving usual outpatient care) experienced a decrease over time. cThe authors used growth modelling analysis, calculated slopes of "average" linear trajectory within a group, averaged across slopes of individual linear trajectories of individual within the group and compared intercepts at each time point and slopes for COPD and CHF patients separately.