Abstract
BACKGROUND: Cardiac caregivers may represent a novel low cost strategy to improve patient adherence to medical follow up, guidelines, and ultimately patient outcomes. Prior work on caregiving has been conducted primarily in mental health and cancer research; few data have systematically evaluated caregivers of cardiac patients. AIMS: The purpose of this study was to evaluate the patterns of caregiving and characteristics of caregivers among hospitalized patients with cardiovascular disease (CVD) to determine the potential pool of caregivers for an educational intervention and assess disparities in caregiver burden. METHODS: Consecutive patients admitted to the CVD service line at a university medical center during a 3 month period were included in the F amily Cardiac Caregiver I nvestigation T o Evaluate O utcomes ( FIT-O ) Study. Patients [N=1415, 55% (776/1415) white, 60% (853/1415) male, >92% participation rate] completed a standardized interviewer assisted questionnaire in English or Spanish regarding assistance with medical care, daily activities, and medications in the past year and plans for post-hospitalization. Caregivers were classified as either paid/professional (e.g. nurse/home aide) or non-paid (e.g. family member/friend). RESULTS: Among CVD patients, 14% (195/1415) planned to have a paid caregiver and 54% (759/1415) a non-paid caregiver at discharge. Planned paid caregiving was more prevalent among black/Hispanic vs. white/other patients (OR=1.8; 95%CI=1.2-2.5); planned non-paid caregiving prevalence did not differ by race/ethnicity. Most non-paid caregivers were female [82% (325/398)]. Patients who had non-paid caregivers in the year prior to hospitalization [(33% (466/1415)] reported: grocery shopping/meal preparation [62% (287/466)], transport to/arranging doctor visits [61% (283/466)], and medication adherence/medical needs [51% (236/466)] as top tasks caregivers assisted with. CONCLUSIONS: Following hospitalization, a majority of patients expect non-paid caregivers, primarily females, to assist with tasks that have the potential to improve CVD outcomes such as medical follow up, medication adherence and nutrition, suggesting these are important targets for a caregiver educational intervention.
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