Longitudinal associations between patient and caregiver quality of life following hematopoietic stem cell transplantation.

Abstract

12087 Background: Caregivers of patients undergoing hematopoietic stem cell transplantation (HSCT) experience high rates of psychological distress, yet patient-level factors most strongly associated with caregiver outcomes over time remain poorly understood. We evaluated longitudinal associations between patient and caregiver quality of life (QoL) following HSCT. Methods: We conducted a secondary analysis of the PROTECT randomized trial of integrated palliative care during HSCT. Among enrolled patient-caregiver dyads, we measured patient (FACT-BMT) and caregiver (CarGOQoL) QoL at baseline, week 2, and months 3, 6, and 12. Only patient-caregiver dyads that completed both measures were included in analyses at each timepoint. Linear mixed-effects models were used to assess the relationship between changes in patient QoL and changes in caregiver QoL, adjusting for time and treatment arm. Results: Among 186 enrolled patient-caregiver dyads, patients had a mean age of 55.2 ± 12.4 years and 65% were male. Mean CarGOQoL remained stable from baseline through month 12 (range: 74.1–75.9). FACT-BMT declined at week 2 (91.9 ± 20.4) compared to baseline (105.0 ± 18.8), then recovered and improved by month 3 through month 12 (Table 1). In multivariable mixed-effects modeling, within dyads, visits where the patient’s QoL exceeded their usual level were associated with higher caregiver QoL (β = 0.11 per 1-point above the patient’s mean; p < 0.001), adjusted for time and arm. Conclusions: While average caregiver QoL remained stable throughout the follow-up period despite changes in average patient QoL, individual caregiver QoL closely tracked their patient's QoL over the post-HSCT follow-up period. Patient-reported QoL represents a clinically meaningful marker to identify at-risk caregivers. Interventions targeting patient QoL may yield dual benefits for patient-caregiver dyads. Clinical trial information: NCT03641378 . Patient and caregiver quality of life by timepoint. Outcome Baseline (n = 183) Week 2 (n = 157) Month 3 (n = 126) Month 6 (n = 112) Month 12 (n = 109) Patient FACT-BMT (mean +/- SD) 105.0 +/- 18.8 91.9 +/- 20.4 107.0 +/- 18.4 111.0 +/- 19.6 112.0 +/- 19.9 Caregiver CarGOQoL (mean +/- SD) 74.1 +/- 12.0 74.1 +/- 12.7 75.9 +/- 12.8 75.8 +/- 13.8 75.7 +/- 14.8 Spearman 0.37 (p < 0.001) 0.27 (p < 0.001) 0.25 (p = 0.004) 0.40 (p < 0.001) 0.38 (p < 0.001)