Background
Multimorbidity is common among older adults, often alongside past or current cancer diagnoses. Such burden of disease is associated with higher rates of depression and anxiety. Available psychological interventions often fail to address the reality of multimorbidity or needs of older patients. The Cancer and Ageing: Reflections for Elders (CARE) program provides a robust theoretical framework potentially applicable to diverse clinical populations especially those with multimorbidity. This study aims to address a gap in psychological interventions for patients with multimorbidity through translation of the CARE model.
Methods
The CARE intervention addresses common themes across ageing and coping with cancer. Built on theoretical frameworks of adaptive coping and developmental challenges of ageing with advanced physical illness, CARE focusing on appraisal and meaning for older people with advanced disease and depression. In an Australian-US collaboration, we are translating the CARE model to patients with chronic non-malignant disease and multimorbidity using a telephone-delivered psychological support program for older Australians facing chronic illness and depression. The protocol and initial feasibility will be presented alongside examples of adaptation of content to address multimorbidity.
Impact on practice
Application of a telephone based psychooncology-based intervention to broader clinical contexts provides an example of potential benefits of psychooncology research to related clinical fields. This may address a gap in psychological interventions for older patients with multimorbidity and advanced chronic disease, while also exploring the comparison of psychosocial themes across disease conditions.
Discussion.
Considering the theoretical foundations of psychological responses to chronic illness and the theoretical basis of interventions across the psychological and mental health fields, it may be possible to more rapidly develop, evaluate, and translate interventions for different health conditions. Our current work will inform development of an intervention trial to test the effectiveness of the revised CARE intervention on clinical outcomes.