Clinician Perspectives on Educate, Nurture, Advise, Before Life Ends Left Ventricular Assist Device (ENABLE-LVAD)...

Family caregivers of patients with left ventricular assist devices (LVADs) experience substantial and unique caregiving demands. Clinicians involved in LVAD care frequently interface with caregivers and are uniquely positioned to provide support. The Educate, Nurture, Advise, Before Life Ends Left Ventricular Assist Device (ENABLE-LVAD) program is an adapted, evidence-based palliative care intervention designed to support caregivers through clinician training and caregiver-facing educational materials.

To understand clinician use, experiences, and perspectives on the ENABLE-LVAD program.

From August 2022 to June 2023, LVAD clinicians who voluntarily registered for ENABLE-LVAD training were invited to participate in semi-structured, audio-recorded interviews. Transcripts were analyzed using content analysis to characterize training completion, program use, and clinician perceptions of feasibility and implementation.

Among 20 interviewed clinicians, 80% completed at least part of the clinician training. Of these clinicians, 50% used all or part of the ENABLE-LVAD program in practice. Clinicians found the asynchronous, modular format accessible, reported learning new information, and agreed the content was well tailored to the LVAD population. Four broad themes emerged: (1) ENABLE-LVAD clinician training was feasible and useful; (2) ENABLE-LVAD program was flexible and adaptable to clinical contexts; (3) ENABLE-LVAD program timing and delivery should be individualized; (4) ENABLE-LVAD program implementation must account for clinical time constraints.

The ENABLE-LVAD program addresses a critical gap in clinician training and caregiver support. Flexible, pragmatic interventions that account for time constraints and existing workflows may enhance caregiver support and inform future program adaptations and randomized trials.