Caregiver burden, quality of life, and psychosocial outcomes among informal caregivers of patients with glioma: A systematic review and meta-analysis

Objective: Informal caregivers of people with glioma frequently provide complex, long-term support in the context of neurological, cognitive and behavioural impairment, which may adversely affect caregiver burden, quality of life (QoL), and broader psychosocial wellbeing, including anxiety, depression, and distress. We synthesised evidence on caregiver burden and psychosocial outcomes among caregivers of patients with glioma, and compared outcomes with caregivers of other cancers where data permitted. Methods: We conducted a systematic review and meta-analysis in accordance with PRISMA 2020. PubMed, Embase, Scopus, PsycINFO and the Cochrane Library were searched from inception to the final search date. Eligible studies reported caregiver burden, QoL, anxiety, depression and/or distress among caregivers of patients with glioma. For single-group analyses, pooled prevalences of burden, anxiety, depression and distress were estimated using random-effects meta-analysis of proportions (Freeman-Tukey transformation). For comparative analyses, standardized mean differences (SMDs) were pooled using random-effects inverse-variance models (DerSimonian-Laird) comparing caregivers of patients with glioma with caregivers of other cancers. Results: Ten studies were included. Clinically significant caregiver burden was common (pooled prevalence = 60%). Pooled prevalences of depression and anxiety were 35% and 36%, respectively, while distress was high (68%). Comparative meta-analysis (3 studies; 710 participants) showed no statistically significant difference in caregiver QoL between glioma and other-cancer caregiver groups (SMD = -0.21). Heterogeneity was substantial across outcomes. Conclusions: Informal caregivers of patients with glioma experience substantial psychosocial morbidity, including high distress, frequent burden, and common anxiety and depressive symptoms. Routine caregiver assessment and integrated caregiver-focused supportive care should be embedded in neuro-oncology pathways.