Principal Investigator: Joan M. Griffin, Ph.D.
Laura Meis, Ph.D.
Maureen Carlyle, M.P.H.
Nancy Greer, Ph.D.
Agnes Jensen, B.S.
Roderick MacDonald, M.S.
Indulis Rutks, B.S.
Evidence-based Synthesis Program (ESP) Center, Minneapolis VA Medical Center, Minneapolis, MN
Washington (DC): Department of Veterans Affairs; April 2013
Two federal laws have been signed in the last five years that have expanded the Veterans Health
Administration's (VHA) authority to provide services to families of Veterans. This expansion
allows the VHA to provide a number of clinical and support services, training, and education
to families and caregivers of patients with service connected and non-service connected
injuries or conditions. The VHA has responded by initiating a set of support services, including
counseling, a caregiver support line, and website, to support families and caregivers of Veterans.
With this new authorization, there is now the potential to adopt or integrate additional familyinvolved
interventions to improve Veteransï¿½ outcomes. This review's aim was to evaluate which
interventions are efficacious in affecting patient outcomes for memory-related disorders or cancer.
Family and caregiver interventions, especially interventions targeted to caregivers caring for
someone with a physical health condition, typically aim to develop caregiver skills to manage
their caregiving tasks and to reduce caregiver burden. An often implicit assumption in these
interventions is that by reducing caregiver burden and improving caregiver skills, the care recipient
will also benefit. Reflecting this, the majority of family-focused intervention studies and reviews of
these studies have concentrated only on family or caregiver outcomes.1-4 We conducted a systematic
review of interventions that explicitly tested this assumption. We evaluated the published evidence
assessing whether family involved interventions improve patient outcomes (i.e., efficacy) and
whether specific family involved interventions are better than alternative ones (i.e., specificity or
comparative effectiveness). We specifically examined the effects of family-involved interventions
on the patients, not on the family members. We assessed if there is evidence that interventions
targeted at family members only or both family members and adult care recipients improve the
patients' outcomes. We limited our focus to family members caring for those with cancer and
memory-related conditions since the majority of studies examine one of these two conditions. This
project was nominated by Sonja Batten, PhD, Office of Mental Health Services. The key questions
and scope were refined with input from a technical expert panel.