Supporting Family Caregiver Health in Heart Failure: Longitudinal Associations Between Heart Failure Caregiver...

Health coaching has been shown to reduce heart failure (HF) caregiver stress and increase caregiver engagement in healthy lifestyle behaviors ("self-care"). The objective of this study was to examine potential downstream effects of improvements in self-care of the caregiver on HF patient hospitalization outcomes.

Data were from a randomized controlled trial testing the efficacy of a health coaching intervention vs information-only control on HF caregiver self-care. Self-care of the caregiver was measured using the Self-Care Inventory. Care recipient hospitalizations and hospitalization days were abstracted from the medical record. Zero-inflated negative binomial models were used to assess the extent to which caregiver self-care improvement, of any degree and regardless of intervention condition, was predictive of patient hospitalization and hospitalization days, adjusting for common confounders. The sample included 125 HF patient-caregiver dyads from both groups, 61.6% of which were spousal/partnered. Nearly two-thirds of caregivers (62.4%) demonstrated self-care improvement. Approximately one-quarter of patients (25.6%) experienced at least 1 hospitalization. Adjusting for confounders, patients with caregivers who improved in self-care experienced significantly fewer hospitalizations (incidence rate ratio 0.332, 95% confidence interval 0.131-0.841, P = .02). No significant effect was observed for hospital days (incidence rate ratio, 0.773, 95% confidence interval 0.271-2.206).

Improvement in HF caregiver self-care was associated with a 67% decrease in patient hospitalizations. Our findings support additional investment in research, programs, and policies that support caregiver health. Our findings may also reassure caregivers, patients, and clinicians that investing time in supporting caregiver health is time well spent and may have potential benefit for patient outcomes.

ClinicalTrials.gov, NCT03988621.