Caregiver health-related quality of life, burden, and patient outcomes in ambulatory advanced heart failure: A report from revival

Nisha A. Gilotra, Salpy V. Pamboukian, Maria Mountis, Shawn W. Robinson, Michelle Kittleson, Keyur B. Shah, Rhondalyn C. Forde-Mclean, Donald C. Haas, Douglas A. Horstmanshof, Ulrich P. Jorde, Stuart D. Russell, Wendy C. Taddei-Peters, Neal Jeffries, Shokoufeh Khalatbari, Catherine A. Spino, Blair Richards, Matheos Yosef, Douglas L. Mann, Garrick C. Stewart, Keith D. AaronsonKathleen L. Grady

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Heart failure (HF) imposes significant burden on patients and caregivers. Longitudinal data on caregiver healthrelated quality of life (HRQOL) and burden in ambulatory advanced HF are limited. METHODS AND RESULTS: Ambulatory patients with advanced HF (n=400) and their participating caregivers (n=95) enrolled in REVIVAL (Registry Evaluation of Vital Information for VADs [Ventricular Assist Devices] in Ambulatory Life) were followed up for 24 months, or until patient death, left ventricular assist device implantation, heart transplantation, or loss to follow-up. Caregiver HRQOL (EuroQol Visual Analog Scale) and burden (Oberst Caregiving Burden Scale) did not change significantly from baseline to follow-up. At time of caregiver enrollment, better patient HRQOL by Kansas City Cardiomyopathy Questionnaire was associated with better caregiver HRQOL (P=0.007) and less burden by both time spent (P<0.0001) and difficulty (P=0.0007) of caregiving tasks. On longitudinal analyses adjusted for baseline values, better patient HRQOL (P=0.034) and being a married caregiver (P=0.016) were independently associated with better caregiver HRQOL. Patients with participating caregivers (versus without) were more likely to prefer left ventricular assist device therapy over time (odds ratio, 1.43; 95% CI, 1.03–1.99; P=0.034). Among patients with participating caregivers, those with nonmarried (versus married) caregivers were at higher composite risk of HF hospitalization, death, heart transplantation or left ventricular assist device implantation (hazard ratio, 2.99; 95% CI, 1.29–6.96; P=0.011). CONCLUSIONS: Patient and caregiver characteristics may impact their HRQOL and other health outcomes over time. Understanding the patient-caregiver relationship may better inform medical decision making and outcomes in ambulatory advanced HF.

Original languageEnglish (US)
Article numbere019901
JournalJournal of the American Heart Association
Volume10
Issue number14
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • Caregiving
  • Heart failure
  • Left ventricular assist device
  • Quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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