Left Ventricular Assist Device Caregiver Experiences and Health Outcomes: A Systematic Review of Qualitative and Quantitative Studies.

Published on Jun 5, 2020in Journal of Cardiac Failure5.712
路 DOI :10.1016/J.CARDFAIL.2020.05.018
Megan Streur5
Estimated H-index: 5
(UW: University of Washington),
Jonathan P. Auld2
Estimated H-index: 2
(UW: University of Washington)
+ 4 AuthorsCynthia M. Dougherty20
Estimated H-index: 20
(UW: University of Washington)
Sources
Abstract
Abstract Background Knowledge synthesis is lacking regarding outcomes and experiences of caregivers of adult patients living with continuous flow left ventricular assist devices (CF-LVAD). The purpose of this systematic review is to summarize qualitative data related to the experience of caregivers of adult patients living with CF-LVAD as well as quantitative data related to health outcomes of caregivers. Methods and Results Multiple databases were systematically queried for studies of qualitative experiences and quantitative health outcomes for caregivers of adult CF-LVAD recipients. Search dates were constrained to articles published between 2004 and August of 2018 as CF-LVADs were not routinely implanted prior to 2004. Two authors independently screened 683 articles; 15 met pre-determined inclusion criteria. Eligible articles reported results from 13 studies. Of those, 8 used either qualitative or mixed-methods and 5 used quantitative methods. Caregivers were primarily female (81%) and mean age was 59 years. Qualitative studies revealed 3 overarching themes related to the caregiver role, coping strategies, and LVAD decisions. Quantitative studies revealed caregiver strain peaked between 1 to 3 months post-implant, anxiety and depression were relatively stable, mental health status improved, and physical health status was stable from pre- to post-implant. Conclusion CF-LVAD caregivers experience significant, sustained emotional strain for 3 months following implantation, reporting considerable stress in meeting their personal needs and those of their loved one.
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References39
Newest
#1Amrut V. Ambardekar (CU: University of Colorado Boulder)H-Index: 24
#2Michelle M. Kittleson (Cedars-Sinai Medical Center)H-Index: 28
Last. Garrick C. Stewart (Harvard University)H-Index: 25
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BACKGROUND The outlook for ambulatory patients with advanced heart failure (HF) and the appropriate timing for left ventricular assist device (LVAD) or transplant remain uncertain. The aim of this study was to better understand disease trajectory and rates of progression to subsequent LVAD therapy and transplant in ambulatory advanced HF. METHODS See Related Editorial, page XXX Patients with advanced HF who were New York Heart Association (NYHA) Class III or IV and Interagency Registry for Mecha...
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#1Colleen K. McIlvennan (University of Colorado Denver)H-Index: 19
#2Daniel D. Matlock (University of Colorado Denver)H-Index: 35
Last. Larry A. Allen (University of Colorado Denver)H-Index: 63
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Abstract Objectives This study aims to characterize caregivers of patients considering destination therapy left ventricular assist device (DT-LVAD) and evaluate the effectiveness of a shared decision-making (SDM) intervention. Background Caregivers play an integral role in the care of patients with chronic illness. At the extreme, pursuing a DT-LVAD is a major preference-sensitive decision that requires high-level caregiver engagement. Yet, little is known about caregivers of patients considerin...
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#1Julie T. Bidwell (OHSU: Oregon Health & Science University)H-Index: 14
#2Karen S. Lyons (OHSU: Oregon Health & Science University)H-Index: 27
Last. Christopher S. Lee (OHSU: Oregon Health & Science University)H-Index: 37
view all 8 authors...
Background Although current guidelines emphasize the importance of social support to the success of left ventricular assist device (LVAD) therapy, few studies examine the influence of the caregiver on patient outcomes or quantify the impact of LVAD caregiving on caregiver outcomes. The purpose of this analysis was to identify patient and caregiver determinants of patient quality of life (QOL) and caregiver strain in response to LVAD therapy. Methods and Results Data on patients receiving LVAD th...
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#1Naoko Perki枚 Kato (UTokyo: University of Tokyo)H-Index: 9
#2Ikuko Okada (UTokyo: University of Tokyo)H-Index: 4
Last. Koichiro Kinugawa (University of Toyama)H-Index: 14
view all 8 authors...
Abstract Background The role of caregivers is important for the successful support of left ventricular assist device (LVAD) patients. We aimed to (1) evaluate quality of life (QoL) of caregivers pre-and post-LVAD implant and (2) identify factors associated with caregivers鈥 QoL. Methods The caregivers鈥 QoL was assessed with the Short Form-8 before implant, at 3 and 6 months after LVAD implantation. The physical and mental component summary (PCS and MCS) scores were calculated. Caregiver burden wa...
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Obiettivi. I pazienti impiantati con un dispositivo di assistenza ventricolare sinistra (LVAD) costituiscono una nuova popolazione di pazienti con scompenso cronico, che richiede continuo supporto medico e rappresenta un costo importante per il sistema sanitario. A fronte di un generale consenso sull鈥檃umento della sopravvivenza, i risultati in termini di benessere psicologico e psicosociale di pazienti e loro caregivers (cioe le persone loro legate affettivamente e che piu se ne occupano) sono a...
#1Julie T. Bidwell (OHSU: Oregon Health & Science University)H-Index: 14
#2Karen S. LyonsH-Index: 27
Last. Christopher S. LeeH-Index: 37
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BACKGROUND: Patients who receive ventricular assist device (VAD) therapy typically rely on informal caregivers (family members or friends) to assist them in managing their device. OBJECTIVE: The purpose of this study is to characterize changes in person-oriented outcomes (quality of life [QOL], depression, and anxiety) for VAD patients and their caregivers together from pre-implantation to 3 months post-implantation. METHODS: This was a formal interim analysis from an ongoing prospective study o...
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#1Randall C. Starling (Cleveland Clinic)H-Index: 102
#2Jerry D. EstepH-Index: 25
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Abstract Objectives The authors sought to provide the pre-specified primary endpoint of the ROADMAP (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients) trial at 2 years. Background The ROADMAP trial was a prospective nonrandomized observational study of 200 patients (97 with a left ventricular assist device [LVAD], 103 on optimal medical management [OMM]) that showed that survival with improved functional s...
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Despite improvements in pharmacological therapy and pacing, prognosis in advanced heart failure (HF) remains poor, with a 1-year mortality of 25鈥50%. While heart transplantation provides excellent survival and quality of life for eligible patients, only a few can be offered this treatment due to shortage of donor organs. Implantable left ventricular assist device (LVAD) technology has improved considerably, and the currently used continuous flow devices may last >10 years in a patient. LVADs are...
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#1Courtenay R. Bruce (BCM: Baylor College of Medicine)H-Index: 15
#2Charles G. MinardH-Index: 25
Last. Kristin M. KostickH-Index: 13
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Background鈥擧ow caregivers contribute to positive or negative outcomes for left ventricular assist device (LVAD) patients remains unclear. Our primary study objectives were to (1) identify caregiver...
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#1Mourad Ouzzani (Qatar Computing Research Institute)H-Index: 34
#2Hossam M. Hammady (Qatar Computing Research Institute)H-Index: 5
Last. Ahmed K. Elmagarmid (Qatar Computing Research Institute)H-Index: 68
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Background Synthesis of multiple randomized controlled trials (RCTs) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions. Filtering of searches is time consuming, and no single method fulfills the principal requirements of speed with accuracy. Automation of systematic reviews is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making. We developed...
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Cited By2
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#2Anna Panzeri (UNIPD: University of Padua)H-Index: 7
Last. Massimo PistonoH-Index: 10
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BACKGROUND After the rehabilitation program, patients with left ventricular assist device (LVAD) are discharged home, but the adaption to the daily life with the implant is challenging, both with practical and psychological consequences. Literature is lacking detailed information about the quality of life of LVAD patients and caregivers after discharge to home. OBJECTIVE This study aimed at evaluating the post-discharge outcomes of both LVAD patients and their caregivers in terms of quality of l...
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#1Sarah Chuzi (NU: Northwestern University)H-Index: 9
#2Adeboye Ogunseitan (NU: Northwestern University)H-Index: 4
Last. Jane E. Wilcox (NU: Northwestern University)H-Index: 14
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Background Patients with left ventricular assist devices (LVADs) implanted as destination therapy may receive suboptimal preparation for and care at the end of life, but there is limited understand...
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