Evaluating the Caregiver Burden Associated with Heart Failure in the United States

Heart failure (HF) involves significant functional impairment and complex treatment plans, and patients “often need the support of unpaid caregivers (CGs),” according to Antoinette Cheung and colleagues. Considering the possible impacts on CG’s health and wellbeing, the investigators explored economic, clinical, and humanistic effects on CGs of patients with HF. Their data, presented at the American College of Cardiology 71st Annual Scientific Session & Expo, demonstrated “the substantial burden to CGs of HF patients, even though estimates of specific elements of CG impact were often sparse and heterogeneous, in particular for economic burden.”

Regardless, Cheung and the study’s contributors advanced that, “despite limited data, notable findings included the wide variation in time spent caregiving and frequent identification of depression among CGs, which may lead to increased healthcare resource use for CGs.”

These observations were based on a systematic literature review of US studies reporting estimates of CG impact within the past 10 years, which returned 44 records. The included patients with HF and CGs were characterized, and the researchers calculated estimates of the burden of caring for those with HF.

The authors’ analysis observed that CGs had a mean age range of 41.4–71.4 years and were primarily female (49–100% in included articles) and the spouse or partner of the patient (21–100%). Six studies reported a range of 2–52 hours per week spent caregiving, and three studies reported a care duration range of 2.9–9.3 years. The authors highlighted two reports, one which observed 24% of CGs had quit their job or reduced their hours, and another which estimated a national annual informal CG cost of over $3 billion. Depression was reported in up to 40% of CGs in nine studies, while one study observed that 30% had anxiety.

The authors acknowledged that, although the instruments used to measure CG burden varied widely, the high impact of caregiving to CGs was consistent across studies—particularly in CGs with anxiety or depression. Ultimately, Cheung and colleagues proposed that “future research is needed to better characterize the CG burden in HF, including the evaluation of drivers of burden.”