Lahoz Raquel, Proudfoot Clare, Fonseca Ana Filipa, Loefroth Emil, Corda Stefano, Jackson James, Cotton Sarah, Studer Rachel
Real World Evidence, Cardiovascular, Renal and Metabolism Franchise, Novartis Pharma AG, Basel, Switzerland.
Health Economics and Outcomes Research, Cardiovascular, Renal and Metabolism Franchise, Novartis Pharma AG, Basel, Switzerland.
Patient Prefer Adherence. 2021 May 26;15:1153-1164. doi: 10.2147/PPA.S297816. eCollection 2021.
To assess the burden among caregivers of patients with heart failure (HF) with left ventricular ejection fraction (LVEF) ≤60%. The burden by New York Heart Association (NYHA) functional class was also characterized.
A cross-sectional study was conducted in France, Germany, Italy, Spain, and UK from June to November 2019. Patient record forms were completed by 257 cardiologists and 158 general practitioners for consecutive HF patients. Caregivers who accompanied the patient to their consultation completed a caregiver self-completion survey voluntarily, which included the Family Caregiver Quality of Life Questionnaire (FAMQOL) and 5-level 5-dimension EuroQol questionnaire (EQ-5D-5L).
We analyzed 361 caregivers of patients with HF (NYHA class I, n=41; II, n=212; III IV, n=108). Mean age of caregivers was 58.8 years (NYHA I/II/III-IV: 59.1/60.8/54.6 years; p=0.0029), with majority being females (73.1%). Caregivers spent on average 19.8 hours/week caring for a HF patient, which increased with increase in NYHA class (I/II/III-IV: 11.8/18.1/25.9 hours/week; p=0.0094). Caregivers (24.1%) reported providing emotional support/encouragement to patients as the most troublesome/inconvenient caregiving activity (no significant difference across NYHA class). Nearly one-third of caregivers experienced stress (NYHA I/II/III-IV: 17.1%/28.8%/40.7%; p=0.0111) and anxiety (26.8%/24.1%/39.8%; p=0.0127) due to caregiving burden. The overall FAMQOL mean score decreased significantly (poorer QoL) with increase in NYHA class (I/II/III-IV: 58.1/56.3/52.2; p=0.0069). A trend of decreasing scores with increasing NYHA class was observed across physical, emotional, and social domains (each p≤0.012).
Caregivers of HF patients with LVEF ≤60% experienced a significant burden, which was higher among caregivers of patients with more severe and symptomatic disease.
评估左心室射血分数（LVEF）≤60%的心力衰竭（HF）患者的照料者负担。还对纽约心脏协会（NYHA）心功能分级对应的负担情况进行了特征分析。
2019年6月至11月在法国、德国、意大利、西班牙和英国进行了一项横断面研究。257名心脏病专家和158名全科医生为连续性HF患者填写患者记录表。陪同患者就诊的照料者自愿完成一份照料者自填式调查问卷，其中包括家庭照料者生活质量问卷（FAMQOL）和5级5维度欧洲生活质量调查问卷（EQ-5D-5L）。
我们分析了361名HF患者的照料者（NYHA I级，n = 41；II级，n = 212；III/IV级，n = 108）。照料者的平均年龄为58.8岁（NYHA I/II/III-IV级：59.1/60.8/54.6岁；p = 0.0029），大多数为女性（73.1%）。照料者平均每周花费19.8小时照料HF患者，且随着NYHA分级的增加而增加（I/II/III-IV级：11.8/18.1/25.9小时/周；p = 0.0094）。24.1%的照料者报告称，为患者提供情感支持/鼓励是最麻烦/不方便的照料活动（NYHA各分级之间无显著差异）。近三分之一的照料者因照料负担而感到压力（NYHA I/II/III-IV级：17.1%/28.8%/40.7%；p = 0.0111）和焦虑（26.8%/24.1%/39.8%；p = 0.0127）。随着NYHA分级的增加，FAMQOL总体平均得分显著降低（生活质量更差）（I/II/III-IV级：58.1/56.3/52.2；p = 0.0069）。在身体、情感和社会领域均观察到随着NYHA分级增加得分下降的趋势（各p≤0.012）。
LVEF≤60%的HF患者照料者负担显著，病情更严重、症状更明显的患者的照料者负担更高。
