title: Providing general practice needs-based care for carers of people with advanced cancer: a randomised controlled trial.
abstract: BACKGROUND
  Carers of patients with advanced cancer often have health and psychosocial needs, which are frequently overlooked.
  
  
  OBJECTIVE
  To meet the needs of carers through a GP consultation directed by a self-completed carer needs checklist.
  
  
  METHODS
  Randomised controlled trial in general practice with recruitment through specialist oncology clinics, in Brisbane, Australia.
  
  
  METHODS
  Intervention was (a) carer-GP consultations directed by a self-completed checklist of needs at baseline and 3 months; and (b) a GP-Toolkit to assist GPs to address carer-identified needs. Control group received usual care. Outcome measures were intensity of needs, anxiety and depression, and quality of life.
  
  
  RESULTS
  Total recruitment 392. Overall, no significant differences were detected in the number or intensity of need between groups. Compared to controls, intervention participants with baseline clinical anxiety showed improvements in mental wellbeing (P = 0.027), and those with baseline clinical depression had slower development of anxiety (P = 0.044) at 6 months. For those not anxious, physical wellbeing improved at 1 month (P = 0.040). Carers looking after patients with poor functional status had more physical needs (P = 0.037) at 1 month and more psychological and emotional needs at 3 months (P = 0.034). Those caring for less unwell patients showed improved mental wellbeing at 3 months (P = 0.022).
  
  
  CONCLUSIONS
  The intervention did not influence the number or intensity of needs reported by carers of people with advanced cancer. There was limited impact in people with pre-existing clinical anxiety and depression. For the carer of those most severely affected by advanced cancer, it drew attention to the needs arising from the caregiving role.
authors.affiliation: Translational Cancer Research Unit, University of New South Wales, Ingham Research Institute, Australia.
authors.forename: Geoffrey K
authors.initials: GK
authors.lastname: Mitchell
authors.forename: Afaf
authors.initials: A
authors.lastname: Girgis
authors.forename: Moyez
authors.initials: M
authors.lastname: Jiwa
authors.forename: David
authors.initials: D
authors.lastname: Sibbritt
authors.forename: Letitia H
authors.initials: LH
authors.lastname: Burridge
authors.forename: Hugh E
authors.initials: HE
authors.lastname: Senior
mesh_terms: D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D017028:Caregivers; D003695:Delivery of Health Care; D003863:Depression / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D058006:General Practice / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000628:therapy*; D011788:Quality of Life; D011793:Queensland; D012647:Self-Assessment