Change in Caregiver Health-Related Quality of Life from before to early after Surgery: Findings from the Sustaining Quality of Life of the Aged: Transplant or Mechanical Support (SUSTAIN-IT) Study

Purpose Understanding health-related quality of life (HRQOL) informs support needs for caregivers (CGs) of patients (pts) with advanced heart failure (HF). We compared HRQOL before/6 months post surgery for CGs of pts undergoing heart transplantation (HT), with or without mechanical circulatory support (MCS), and destination therapy (DT) MCS. Methods Between 10/1/15-12/31/18 we enrolled 302 CGs from 12 U.S. sites: 89 HT with MCS, 104 HT without MCS, and 109 DT MCS. CGs completed the EQ-5D-3L (Visual Analog Scale [VAS]: 0 [worst] to 100 [best] imaginable health state and 5 HRQOL dimensions), PHQ-8 (range = 0-24 with ≥10 = significant depressive symptoms), and STAI-state (range = 20-80; higher score = more anxiety). Results CGs were aged 61.0±10.3 years, majority were spouses (85%), female (86%), and white (86%). CGs reported high overall HRQOL before (83.9±14.0) and after (82.9±15.7) surgery, with no significant differences between groups. CGs in all 3 groups reported low baseline (2.6±2.9) and follow-up (2.9±3.9) depressive symptoms. DT CGs reported significantly higher baseline anxiety levels compared to HT-MCS and HT-non MCS. DT and HT-non MCS caregivers showed significantly reduced anxiety levels over time. See Figure. There were no significant differences in anxiety between groups 6 months post-surgery. Conclusions CGs of pts with advanced HF reported relatively high levels of HRQOL and low levels of depression at baseline and early after surgery. DT CGs reported higher baseline anxiety levels when compared to CGs of HT pts. At 6 months, anxiety levels were similar and low for all groups, suggesting CG adjustment. Identifying CG psychological distress may inform support options and potential treatment.