Integrating Community‐Based Palliative Care With Primary Health Care: Effect on Quality of Life of Family Caregivers of Advanced Cancer Patients—Randomized Controlled Trial

Background

Family caregivers of patients with advanced cancer experience considerable emotional, physical, and financial challenges that undermine their quality of life (QoL). Although community‐based palliative care has shown positive effects on patient outcomes, its impact on caregivers remains uncertain. Given this uncertainty, this study, nested within a larger trial designed to evaluate patient palliative outcomes, aimed to determine the effects of community‐based palliative care integrated with primary health care (PHC) on caregiver QoL as a secondary outcome.

Methods

This two‐arm, parallel‐group, stratified block randomized controlled trial included 120 patients with advanced cancer and their family caregivers from comprehensive health centers in 2023. Participants were randomly assigned to intervention ( n  = 60) or control ( n  = 60) groups. The intervention group received integrated community‐based palliative care over 2 months; controls received routine care. Caregivers completed the QOLLTI‐F questionnaire at baseline and 2 months postintervention. The parent trial’s primary outcome was patient palliative outcomes; caregiver QoL was secondary. Data were analyzed using SPSS version 19 with descriptive and inferential statistics.

Results

Baseline characteristics were comparable between groups ( P  > 0.05). The intervention group showed significantly greater overall QoL improvement than controls (Δ = +12.16; 95% CI: 10.95–13.37; p  < 0.001; d  = 2.50). Significant improvements were observed in all dimensions except physical ( d  = 0.02) and financial ( d  = 0.05). Domain‐specific effect sizes ranged from negligible (physical) to very large (emotional, d  = 1.95).

Conclusion

Community‐based palliative care integrated with PHC significantly improved overall QoL and several domains among family caregivers of advanced cancer patients. These findings support integrating such services into PHC to enhance QoL for affected families.

Trial Registration: Iranian Registry of Clinical Trials: IRCT20180721040540N5