Prevalence and Predicting Factors of Caregiver Burden in Cirrhotic Patients

Cirrhosis is a major cause of morbidity and mortality. Caregivers of cirrhotic patients provide significant support related to disease manifestations and complications. This scoping review aims to identify the prevalence of caregiver burden among patients with cirrhosis and to identify patient and caregiver factors that predict caregiver burden in patients with cirrhosis.

A literature search was conducted using MEDLINE, EMBASE, CINAHL, and Web of Science to identify studies for inclusion. Screening and data extraction were performed using Covidence systematic review software (Veritas Health Innovation, Melbourne, Australia).

604 articles were identified, and 15 were included in the review. Caregivers were predominantly female and spouses of the patient. The average age of patients varied between 41.2 and 57.2 (SD 10.3 to 12.5). The most common cirrhotic aetiologies were alcohol-related, viral hepatitis-related, and metabolic-related aetiologies. The most used survey tools to assess burden were the Zarit Burden Interview (ZBI) score, Short Form-36 Health Survey (SF-36), and Beck Depression/Anxiety Inventory (BDI or BAI). Patient factors contributing toward caregiver burden included prior hepatic encephalopathy (HE), alcohol use, and high Model for End-Stage Liver Disease (MELD) scores. Caregiver factors that contribute toward caregiver burden included poor perceived social supports, low and disrupted income, and being the spouse of the patient.

Several patient and caregiver factors contribute to caregiver burden, and greater levels of burden may affect multiple aspects of a caregiver's life, potentially worsening patient outcomes. A multidisciplinary approach is critical to alleviate caregiver burnout and optimize the overall care for a patient with cirrhosis.