Abstract 16318: Care Dyadic Types in Patients With Multiple Chronic Conditions and Their Caregivers

Abstract

Introduction: Multiple Chronic Conditions (MCC) are highly prevalent in patients with cardiovascular diseases. Patients’ informal caregivers play an essential role to achieve both patient and caregiver health outcomes. Four Care Dyadic Types (DTs) of caregiver-patient relationships were previously described in heart failure depending on who is responsible for most of the care: patient-oriented, caregiver-oriented, collaborative, and incongruent (i.e., disagreement on who is responsible for the care). Since DTs in MCC were not described yet, this study aimed to describe the DTs in MCC management, and to identify the patient and caregiver characteristics associated with each type of DT. Methods: We conducted a cross-sectional study enrolling 541 dyads in outpatient settings in Italy. Patients were included in the study if they were ≥65 years old, affected by at least two chronic conditions, and had an informal caregiver ≥18 years old. The Dyadic Symptom Management Type scale was used to assess DTs. Logistic regression analysis was used to identify the characteristics associated with each DT. Results: Most patients and caregivers were female with a mean age of 76.54 (SD 7.23) years and 52.71 (SD 15.06) years, respectively. One third of the patients had heart failure. Younger patients with better cognitive status, fewer comorbidities, better relationship with their caregivers and male caregivers with a lower burden were associated with patient-oriented DT (14.2%, R 2 0.407). Older patients and caregivers with a higher burden were associated with caregiver-oriented DT (11.6%, R 2 0.388). Patients with more comorbidities, better relationship with their caregivers, and female caregivers with lower burden, perceiving strong social support, were associated with collaborative DT (58.8%, R 2 0.097). Caregivers with lower income, more frequently employed, providing more caregiving hours, and having a lower burden were associated with incongruent DT (15.4%, R 2 0.075). Conclusion: Different DTs were described in MCCs identifying specific patients and caregivers’ associated characteristics. This is helpful to classify the dyads and to tailor interventions aimed to empower patients and caregivers in MCCs.