Abstract
ImportanceWhen caregivers cannot attend the clinic visit for the person they provide care for, patients are the predominant source of clinic visit information; however, poor patient recall inhibits the quality of information shared, resulting in poor caregiver preparedness and contributing to caregiver morbidity. Technological solutions exist to sharing clinic visit information, but their effectiveness is unclear.ObjectivesTo assess if and how technology is being used to connect informal caregivers to patient clinic visit information when they cannot otherwise attend, and its impact on caregiver and patient outcomes.Evidence reviewMEDLINE, Cochrane, Scopus, and CINAHL were searched through 5/3/2020 with no language restrictions or limits. ClinicalTrials.gov and other reference lists were included in the search. Randomized controlled trials (RCTs) and nonrandomized trials that involved using a technological medium e.g., video or the electronic health record, to communicate visit information to a non-attending caregiver were included. Data were collected and screened using a standardized data collection form. Cochrane’s Risk of Bias 2.0 and the Newcastle-Ottawa Scale were used for RCTs and nonrandomized trials, respectively. All data were abstracted by two independent reviewers, with disagreements resolved by a third reviewer.FindingsOf 2115 studies identified in the search, four met criteria for inclusion. Two studies were randomized controlled trials and two were nonrandomized trials. All four studies found positive effects of their intervention on caregiver outcomes of interest, and three out of four studies found statistically significant improvements in key outcomes for caregivers receiving visit information. Improved outcomes included caregiver happiness, caregiver activation, caregiver preparedness, and caregiver confidence in managing patient health.Conclusions and relevanceOur review suggests that using technology to give a caregiver access to clinical visit information could be beneficial to various caregiver outcomes. There is an urgent need to address the lack of research in this area.
Highlights
The proportion of Americans aged 65 years of age or older is expected to double in the 20 years [1]
Our review suggests that using technology to give a caregiver access to clinical visit information could be beneficial to various caregiver outcomes
Technologies are defined in the broadest sense: the application of scientific knowledge to practical purposes, in this case those that provide a record of clinic visit information to caregivers, and evaluated caregiver outcome measures, were included in our review
Summary
The proportion of Americans aged 65 years of age or older is expected to double in the 20 years [1]. Among older adults in 2020, 77% are managing two or more chronic diseases; this percentage is steadily increasing [2,3,4] Assistance in managing these conditions is often provided by informal caregivers: spouses, family members, or friends ‘who provide unpaid, athome care to someone with whom they have a personal relationship [5,6]. In America, 53 million individuals identify as informal caregivers; 78% of those provide care for an adult over the age of 50 [7] This increasing comorbidity of conditions that require care, with caregivers reporting their recipient has 1.7 conditions categories on average (up from 1.5 in 2015), suggests that are more American adults taking on the role of unpaid caregiver, but they are doing so for adult recipients who may have increasingly complex medical or support needs [7]. Caregiving is considered a vital stress factor event, and 64% of caregivers report high or moderate stress caused by their caregiving, while up to 70% of caregivers display clinically significant symptoms of depression [13,14]
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