Randomized controlled trial of a home-based palliative approach for people with severe multiple sclerosis

Alessandra Solari, Andrea Giordano, Francesco Patti, Maria Grazia Grasso, Paolo Confalonieri, Lucia Palmisano, Michela Ponzio, Claudia Borreani, Rosalba Rosato, Simone Veronese, Paola Zaratin, Mario Alberto Battaglia, PeNSAMI Project

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BACKGROUND: Evidence on the efficacy of palliative care in persons with severe multiple sclerosis (MS) is scarce.

OBJECTIVE: To assess the efficacy of a home-based palliative approach (HPA) for adults with severe MS and their carers.

METHODS: Adults with severe MS-carer dyads were assigned (2:1 ratio) to either HPA or usual care (UC). At each center, a multi-professional team delivered the 6-month intervention. A blind examiner assessed dyads at baseline, 3 months, and 6 months. Primary outcome measures were Palliative care Outcome Scale-Symptoms-MS (POS-S-MS) and Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW, not assessed in severely cognitively compromised patients).

RESULTS: Of 78 dyads randomized, 76 (50 HPA, 26 UC) were analyzed. Symptom burden (POS-S-MS) significantly reduced in HPA group compared to UC ( p = 0.047). Effect size was 0.20 at 3 months and 0.32 at 6 months, and statistical significance was borderline in per-protocol analysis ( p = 0.062). Changes in SEIQoL-DW index did not differ in the two groups, as changes in secondary patient and carer outcomes.

CONCLUSION: HPA slightly reduced symptoms burden. We found no evidence of HPA efficacy on patient quality of life and on secondary outcomes.

Original languageEnglish
Pages (from-to)1352458517704078
JournalMultiple Sclerosis
Publication statusE-pub ahead of print - Apr 1 2017


  • Journal Article


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