Abstract 12062: Patient and Caregiver Heart Failure Symptom Response Behaviors in 364 Patient-Caregiver Dyads

Introduction: Recognition and response to symptoms of heart failure (HF) is critical to reducing the risk of hospitalization and mortality. Although many patients have support from caregivers, little is known about caregivers’ contributions to HF symptom response behaviors. We hypothesized that patient-, caregiver-, and dyad-level factors would be associated with better symptom response behaviors. Methods: This was a secondary analysis of data on 364 Italian HF patient-caregiver dyads. HF symptom response behaviors were measured using patient and caregiver versions of the Self-Care of Heart Failure Index (0-100; higher = better). Health status (SF-12) and relationship quality (single item) were collected from patients and caregivers. Patient cognition and comorbidities were measured using the MMSE and Charlson Index. Caregiver social support was measured with the Carers of Older People in Europe Index. Hospitalizations were abstracted from the medical record. Multilevel modeling was used for all analyses. Results: Patients were older (age 76.3±10.8 years), predominantly male (57.3%) and most had NYHA Class II/III HF (72.2%). Caregivers were younger (age 57.7±14.6 years), and most were female (51.7%) and adult child (53.6%) or spousal (34.0%) caregivers. Symptom response behaviors were poor in patients (49.1±19.6) and caregivers (54.7±18.3). Patient gender (male β=-4.60±1.92, p<0.05), better cognition (β=0.40±0.19, p<0.05), worse caregiver health (β=-0.43±0.14, p<0.01), and higher relationship quality (β=2.28±0.83, p<0.01) were significant determinants of better patient symptom response. Nonspousal relationship (β=6.62±1.96, p<0.001), fewer patient comorbidities (β=-2.32±0.79, p<0.01), better patient health (β=0.41±0.12, p=0.001), more hospitalizations (β=3.06±1.41, p<0.05), higher relationship quality (β=2.12±0.84, p<0.01), and higher caregiver social support (β=1.09±0.43, p<0.05) were significant determinants of better caregiver symptom response. Conclusions: Combinations of individual and relationship factors were significant determinants of patient and caregiver responses to HF symptoms. Assessment of patient and caregiver as a dyad may be useful in evaluating risk for poor management of HF symptoms.