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Objectives Patient satisfaction with having a left ventricular assist device (LVAD) as a bridge to transplantation (BTT) or destination therapy (DT) may change over time early after surgery, as patients adjust to life on a device. We examined satisfaction at 2 time points early after surgery. Methods We evaluated patient self-report data at 3 and 6 months (mos) post implant at 12 U.S. sites (2016-2020). Measures included Satisfaction with Treatment (10 items, [FACIT-TS-G, modified]), VAD Team Communication (6 items, 0 [worst] - 18 [best] communication as wanted, [FACIT-TS-PS, modified]), and Being Bothered by VAD Self-care and Limitations (17 items, 1 [not] - 5 [very much] bothered, [new items]). Bowker's symmetry test was used to compare change in satisfaction for the 10 satisfaction items. Mixed effects models were estimated to assess change in VAD team communication and bother, assuming a missing at random mechanism. Results Patients (n=115) were primarily male (77%) and non-Hispanic White (65%); mean age(SD)=55 ( 12.5) years; 50% had an implant strategy of DT. Overall, no differences were detected regarding satisfaction with having a VAD between 3 and 6 mos after implant. 61% of patients (n=71) were satisfied (for the most part or completely) at 3 mos; of these, 63 (89%) responded similarly at 6 mos. Satisfaction with VAD team communication was high (least-squares means at 3 and 6 mos: 12.3 and 12.8) and being bothered by VAD self-care and limitations was low to moderate (least-squares means at 3 and 6 mos: 2.3 and 2.4), with no change over time (p>0.40). BTT and DT patients reported similar bother (p=0.21), but BTT patient satisfaction with communication was marginally higher than DT patients (p=0.05). Conclusions Patients were quite satisfied with having a VAD early after implant. Patients were also satisfied with communication from the VAD team and reported moderate or fewer hassles with having a VAD, which did not differ by implant strategy. Understanding satisfaction with a VAD may guide patient support early post implant.

Introduction Social health (i.e., ability and satisfaction with ability to participate in family, work, and leisure activities) among patients (pts) with advanced heart failure (HF) who undergo left ventricular assist device (LVAD) implantation is incompletely described. This report evaluated social health across three time periods (early, mid, and later) after implantation. Methods We evaluated data from 183 pts with LVADs who were ≤6 months, >6-24 months, and >24 months post-implant at 9 U.S. sites (10/26/16 - 12/31/18). Measures of social health included overall social health and satisfaction with social function (PROMIS v1.1) and multi-item measures of social function and satisfaction with social function (PROMIS v2.0). Tests for differences between implant groups included χ2 tests and ANOVAs. Results Pts at all 3 time periods were, on average, middle-aged; the majority were male, white, and well educated. Etiology of HF and pre-implant strategy were similar among groups. The majority of pts at all 3 time periods reported good to excellent overall ability to carry out usual social activities and roles, and satisfaction with social activities and relationships. Approximately 20% to 30% of patients in all 3 groups reported fair or poor overall social function/ability, and fair or poor satisfaction with social activities and relationships. For all 3 groups, ability to participate in social roles and activities, and satisfaction with social roles and activities approximated the U.S. general population mean of 50. Conclusions Regardless of time since implant, the majority of LVAD pts were able to participate in social activities and were satisfied with their social health. For the subset of patients who reported lower social functioning and satisfaction, future work should focus on developing effective interventions. These findings highlight the importance of assessing social health after LVAD implantation.

The optimal strategy for promoting self-care for heart failure (HF) is unclear.We conducted a randomized trial to determine whether a "teach to goal" (TTG) educational and behavioral support program provided incremental benefits to a brief (1 hour) educational intervention (BEI) for knowledge, self-care behaviors, and HF-related quality of life (HFQOL). The TTG program taught use of adjusted-dose diuretics and then reinforced learning goals and behaviors with 5 to 8 telephone counseling sessions over 1 month. Participants' (n = 605) mean age was 61 years; 37% had marginal or inadequate literacy; 69% had ejection fraction0.45; and 31% had Class III or IV symptoms. The TTG group had greater improvements in general and salt knowledge (P.001) and greater increases in self-care behaviors (from mean 4.8 to 7.6 for TTG vs. 5.2 to 6.7 for BEI; P.001). HFQOL improved from 58.5 to 64.6 for the TTG group but did not change for the BEI group (64.7 to 63.9; P.001 for the difference in change scores). Improvements were similar regardless of participants' literacy level.Telephone reinforcement of learning goals and self-care behaviors improved knowledge, health behaviors, and HF-related QOL compared to a single education session.