Abstract 15794: Changes in Patient and Caregiver Depression and Anxiety Post-implantation of a Ventricular Assist Device

Abstract

Introduction: The impact of ventricular assist device (VAD) therapy on affective symptoms among patients with advanced heart failure (HF) and their informal caregivers is not well understood. Hypothesis: We hypothesized that patients’ affective symptoms would improve post-implant, while caregivers’ affective symptoms would worsen. Methods: Prospective, longitudinal data was collected on patients and their caregivers (n=25 dyads) prior to and at 30 and 90 days after VAD implantation. Depression was measured using the Patient Health Questionnaire-8 (PHQ-8; range 0-24, higher scores indicate worse depressive symptoms), and anxiety was measured using the Anxiety Scale of the Brief Symptom Inventory (BSI-ANX; range 0-4; higher scores indicate worse anxiety) in patients and their caregivers. Pre vs. post VAD comparisons in affective symptoms were examined using paired t-tests. Results: Patients requiring VAD implantation were 54.9±12.5 years of age and mostly male (84.0%), while caregivers were 53.9±11.1 years of age and mostly female (80.0%); a majority (72.0%) of dyads were spouses. Patient depression decreased significantly from pre-implant (9.3±5.6) to 30 days (6.9±5.4; t=2.2, p=0.04) and 90 days post-implant (3.6±3.6; t=5.3, p<0.01); patient anxiety also decreased from pre-implant (1.0±0.9) to 30 days (0.5±0.7; t=2.9, p<0.01) and 90 days post-implant (0.3±0.4; t=4.5, p<0.01). In contrast, there were no significant changes in caregiver depression from pre-implant (6.0±5.2) to 30 days (5.2±4.4; t=0.5, p=0.6) and 90 days post-implant (6.6±5.7; t=-0.4, p=0.7) or in caregiver anxiety from pre-implant (0.8±0.6) to 30 days (0.5±0.4; t=1.5, p=0.2) and 90 days post-implant (0.6±0.7; t=0.9, p=0.4). Conclusions: Although depression and anxiety improved dramatically for patients after VAD implantation, the pre-implant affective symptom burden of caregivers was substantially higher than national norms at baseline and was not ameliorated over time. As patient symptoms improve with VAD therapy, their caregivers may benefit from psychosocial interventions to address protracted symptoms of depression and anxiety.