Abstract 285: An Assessment of Factors Associated With Caregiver Burden in Atrial Fibrillation

Abstract

Background: Nearly one-third of the unpaid adult caregivers in the United States aid in managing heart or cerebrovascular disease. Atrial fibrillation (AF) is the most common cardiac arrhythmia, increasing patients' stroke risk. To date, the burden on caregivers supporting AF patients has not been evaluated. We sought to examine the interrelationship between caregiver, patient and anti-clot treatment characteristics and perceived caregiver burden in AF. Methods: We conducted a cross-sectional survey study of AF patient-caregiver dyads recruited from the cardiology clinics of a large, urban teaching hospital. Eligible patients had AF, were receiving antithrombotic agents for stroke prevention, lived in the community and had an unpaid, English-speaking, adult caregiver. Hierarchical multivariate linear regression was used to evaluate the association between caregiver, patient and anti-clot treatment characteristics and caregiver burden as measured by the validated Caregiver Reaction Assessment (CRA). Results: Eighty AF patient-caregiver dyads completed the survey. The mean (±SD) scores for the 5 CRA domains were: Disrupted schedule (2.4±1.0), Financial problems (2.1±0.8), Lack of family support (1.9±0.7), Health problems (1.9±0.7) and Self-esteem (0.9±0.5). Significantly greater caregiver burden due to Disrupted schedule was seen in those spending >4 hours/week providing care and when caring for frail, sick or disabled patients, with higher CHADS2 scores and requiring help with their medications (p<0.05). Financial problems burden scores were significantly associated with caring for frail patients and those requiring more frequent office follow-up (p<0.05). Lack of family support scores increased as patients' CHADS2 score increased and were inversely associated with having another individual to assist with care. Worse Health problem burden scores were associated with female gender and the need to spend >4 hours/week providing care. Conclusion: Our results suggest that caregivers of AF patients incur the greatest burden due to disruption in schedule. Health care professionals should be cognizant of this, and the other sources of caregiver burden, when managing AF patients.