Change in Patient Signs-Symptoms at 90 Days and Caregiver Burden, QoL and ADL Support Needs

Abstract

Introduction Caregivers (CG) support for pts with HF can be burdensome and affect their quality of life (QoL). It is unknown if changes in pt. sign/symptom (SS) at 90-days is associated with a change in pt NYHA-FC and CG ADL support, caregiving burden, and QoL. Methods Pt-CG dyads (N=132) were recruited from 3 hospitals (1 OH and 2 TN sites) and completed surveys at baseline on demographics, SS, NYHA-FC and perceived ADL needs (pts) and ADL support, caregiving burden and QoL (CGs). At 90 days, pts completed SS and NYHA-FC data and CGs provided caregiving burden and QoL. Descriptive statistics of median standardized sum scores and frequencies were compared and multivariable proportional odds logistic regression and linear regression models were fit to evaluate change in pt SS and NYHA FC and CG caregiving burden and QoL. Results Of 132 pt-CG dyads, pts mean (SD) age was 67.95 (12.88) years, mean (SD) EF% was 40.5% (16.6%), 69.7% were male and 78.8% were married. Mean LVEF was 40.46 (16.60)% and NYHA-FC II/III/IV status was 32.6%/46.2%/21.2%. Of CGs, mean age was 63.72(10.64) years and 81.1% were female. At baseline and 90 days, median standardized sum scores for CG caregiving burden (30.8 [17.8, 46.6] vs. 28.4 [14.4, 40.9]) and QoL (72.5 [62.5, 82.5] vs 72.5 [63.8, 82.5]) were similar. Of pt SS, most common at baseline were dyspnea beyond ADL (75.0%), edema-feet (70.5) and nocturia (65.2%); at 90 days, nocturia (74.2%) and napping 4+ days/week (60.6%). Overall median [P25, P75] standardized SS sum score decreased at 90 days (31.1 [21.9, 40.6] to 20.3 [12.5, 31.3]; change, -0.56), p Conclusion Compared to decreasing or increasing pt SS at 90 days, CGs of pts with stable SS had greater caregiver burden, lower QoL and completed more HF-related ADL support needs.