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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | e011705 |
| Journal | Circulation: Heart Failure |
| Volume | 17 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 1 2024 |
Funding
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. This work was sponsored by the National Institutes of Health , National Institute on Aging , SUSTAIN-IT (Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Circulatory Support; R01AG047416, to Dr Grady); ClinicalTrials.gov ID: NCT02568930. Dr Nguyen is currently supported by the National Heart, Blood, and Lung Institute under Award T32H110837. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Keywords
- caregiver burden
- heart failure
- heart transplantation
- heart-assist devices
- quality of life
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine