1. Association of Patient Reported Outcomes With Caregiver Burden in Older Patients With Advanced Heart Failure: Insights From the SUSTAIN-IT Study.
- Author
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Nguyen DD, Spertus JA, Benton MC, Thomas M, Jones PG, Andrei AC, Wu T, Baldridge AS, and Grady KL
- Subjects
- Humans, Female, Male, Aged, Middle Aged, Aged, 80 and over, Caregivers psychology, Caregiver Burden psychology, Health Status, Quality of Life, Surveys and Questionnaires, United States, Time Factors, Cost of Illness, Heart Failure therapy, Heart Failure psychology, Heart-Assist Devices, Heart Transplantation, Patient Reported Outcome Measures
- Abstract
Background: Caregivers of patients with advanced heart failure may experience burden in providing care, but whether changes in patient health status are associated with caregiver burden is unknown., Methods: This observational study included older patients (60-80 years old) receiving advanced surgical heart failure therapies and their caregivers at 13 US sites. Patient health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire (range, 0-100; higher scores are better). Caregiver burden was assessed using the Oberst Caregiving Burden Scale, which measures time on task (OCBS-time) and task difficulty (OCBS-difficulty; range, 1-5; lower scores are better). Measurements occurred before surgery and 12 months after in 3 advanced heart failure cohorts: patients receiving long-term left ventricular assist device support; heart transplantation with pretransplant left ventricular assist device support; and heart transplantation without pretransplant left ventricular assist device support. Multivariable linear regression was used to identify predictors of change in OCBS-time and OCBS-difficulty at 12 months., Results: Of 162 caregivers, the mean age was 61.0±9.4 years, 139 (86%) were female, and 140 (86%) were the patient's spouse. At 12 months, 99 (61.1%) caregivers experienced improved OCBS-time, and 61 (37.7%) experienced improved OCBS-difficulty (versus no change or worse OCBS). A 10-point higher baseline 12-item Kansas City Cardiomyopathy Questionnaire predicted lower 12-month OCBS-time (β=-0.09 [95% CI, -0.14 to -0.03]; P <0.001) and OCBS-difficulty (β=-0.08 [95% CI, -0.12 to -0.05]; P <0.001). Each 10-point improvement in the 12-item Kansas City Cardiomyopathy Questionnaire predicted lower 12-month OCBS-time (β=-0.07 [95% CI, -0.12 to -0.03]; P =0.002) and OCBS-difficulty (β=-0.09 [95% CI, -0.12 to -0.06]; P <0.001)., Conclusions: Among survivors at 12 months, baseline and change in patient health status were associated with subsequent caregiver time on task and task difficulty in dyads receiving advanced heart failure surgical therapies, highlighting the potential for serial 12-item Kansas City Cardiomyopathy Questionnaire assessments to identify caregivers at risk of increased burden., Registration: URL: https://www.clinicaltrials.gov; unique identifier: NCT02568930., Competing Interests: Dr Grady is the principal investigator of grants from the National Heart, Lung, and Blood Institute; receives speaker fees from the American Heart Association; and served on the Board of Directors for the International Society for Heart and Lung Transplantation. Dr Spertus is the principal investigator of grants from Myokardia and Janssen; is a consultant to Myokardia, Bristol Meyers Squibb, Merck, Novartis, Pfizer, and Janssen; serves on the Scientific Advisory Board of United Healthcare and the Board of Directors for Blue Cross Blue Shield of Kansas City; and owns the copyright to the Kansas City Cardiomyopathy Questionnaire, Seattle Angina Questionnaire, and Peripheral Artery Questionnaire. The other authors report no conflicts.
- Published
- 2024
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