Symptom Burden, Depression, and Spiritual Well-Being: A Comparison of Heart Failure and Advanced Cancer Patients

Bekelman, David B.; Rumsfeld, John S.; Havranek, Edward P.; Yamashita, Traci E.; Hutt, Evelyn; Gottlieb, Sheldon H.; Dy, Sydney M.; Kutner, Jean S.

doi:10.1007/s11606-009-0931-y

Cited by 244 publications

(176 citation statements)

References 67 publications

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“…1 People with this debilitating disorder experience a number of symptoms that diminish their health-related quality of life, including dyspnea and fatigue. [2][3][4] Although dyspnea and fatigue are the hallmark symptoms of heart failure, depression and depressive symptoms are major problems that occur frequently among persons with chronic heart failure. 5,6 The prevalence of depression in persons with advanced cardiovascular conditions such as heart failure is widespread, leading the American Heart Association to issue an advisory statement recommending screening of all patients with coronary heart disease for depression.…”

Section: Methodsmentioning

confidence: 99%

Measuring Depressive Symptoms in Heart Failure: Validity and Reliability of the Patient Health Questionnaire-8

Pressler¹,

Subramanian²,

Perkins³

et al. 2010

American Journal of Critical Care

103

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Section: Methodsmentioning

confidence: 99%

Measuring Depressive Symptoms in Heart Failure: Validity and Reliability of the Patient Health Questionnaire-8

Pressler¹,

Subramanian²,

Perkins³

et al. 2010

American Journal of Critical Care

103

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“…2,[12][13][14][15] This seems logical, since persons with advanced HF and their families, like patients with cancer, bear the brunt of unaddressed physical pain and emotional suffering, face a number of complex and difficult medical decisions, 2 and weather multiple hospitalizations in their last year of life. 7,9,[16][17][18][19][20][21] Initiation of interdisciplinary palliative care services beginning early in the course of advanced HF has been strongly recommended as a critical strategy in addressing these challenges by professional groups 6,15,19,[25][26][27][28][29] including the AHA 25 and many others. 5,15,22,23 However, few PC models have undergone systematic development and testing to address the individualized needs of patients with advanced HF and their family caregivers, especially for those in community-based rural locations where geographic distances and access to care can present significant challenges.…”

Section: Introductionmentioning

confidence: 99%

Translating and Testing the ENABLE: CHF-PC Concurrent Palliative Care Model for Older Adults with Heart Failure and Their Family Caregivers

Dionne‐Odom

KonoAlan

FrostJennifer

et al. 2014

Journal of Palliative Medicine

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Background: Heart failure (HF) and palliative care (PC) organizations recommend early PC to improve the quality of life of patients living with HF. Objective: We conducted a two-phase formative evaluation study to translate a cancer-focused concurrent PC intervention into one that would be appropriate for rural-dwelling adults with New York Heart Association Class III-IV HF and their primary caregivers. Methods: Phase I: We tailored the intervention for an HF population via literature review, expert consultation, and clinician (N = 15) small group interviews. Phase II: We enrolled 11 patient/caregiver dyads to assess intervention feasibility and satisfaction. We assessed participants' experiences and satisfaction after session/ week three and session/week six via digitally recorded interviews. Clinician and participant interviews were transcribed and content analyzed. Outcome measures were evaluated for completion rates and effect sizes. Results: Phase I: Clinicians described barriers to initiating PC in HF, triggers for initiating PC, and suggestions for intervention improvement. Phase II: Participants were able to complete the majority of study sessions, measures, and interviews. Satisfaction interviews revealed the content to be relevant and comprehensive in addressing HF patient and caregiver primary concerns; however, participants unanimously suggested making the intervention available earlier in the illness trajectory. Efficacy measures demonstrated small to medium effect sizes. Conclusions:We tailored and demonstrated feasibility of providing an early, concurrent palliative care intervention to patients with advanced HF and their caregivers. Based on this experience we are now conducting an efficacy trial in a racially diverse sample.

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“…The palliative care needs of symptomatic patients with heart failure are comparable to those of patients with advanced cancer. 104,105 These burdens also affect caregiver quality of life. 13,27,87,102,[106][107][108] However, patients and caregivers with heart failure access palliative services far less often than patients with cancer.…”

Section: May 8 2018mentioning

confidence: 99%

Projected Costs of Informal Caregiving for Cardiovascular Disease: 2015 to 2035: A Policy Statement From the American Heart Association

Dunbar¹,

Khavjou²,

Bakas³

et al. 2018

Circulation

179

102

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INTRODUCTION:In a recent report, the American Heart Association estimated that medical costs and productivity losses of cardiovascular disease (CVD) are expected to grow from $555 billion in 2015 to $1.1 trillion in 2035. Although the burden is significant, the estimate does not include the costs of family, informal, or unpaid caregiving provided to patients with CVD. In this analysis, we estimated projections of costs of informal caregiving attributable to CVD for 2015 to 2035. METHODS:We used data from the 2014 Health and Retirement Survey to estimate hours of informal caregiving for individuals with CVD by age/sex/race using a zero-inflated binomial model and controlling for sociodemographic factors and health conditions. Costs of informal caregiving were estimated separately for hypertension, coronary heart disease, heart failure, stroke, and other heart disease. We analyzed data from a nationally representative sample of 16 731 noninstitutionalized adults ≥54 years of age. The value of caregiving hours was monetized by the use of home health aide workers' wages. The per-person costs were multiplied by census population counts to estimate nation-level costs and to be consistent with other American Heart Association analyses of burden of CVD, and the costs were projected from 2015 through 2035, assuming that within each age/sex/racial group, CVD prevalence and caregiving hours remain constant. RESULTS:The costs of informal caregiving for patients with CVD were estimated to be $61 billion in 2015 and are projected to increase to $128 billion in 2035. Costs of informal caregiving of patients with stroke constitute more than half of the total costs of CVD informal caregiving ($31 billion in 2015 and $66 billion in 2035). By age, costs are the highest among those 65 to 79 years of age in 2015 but are expected to be surpassed by costs among those ≥80 years of age by 2035. Costs of informal caregiving for patients with CVD represent an additional 11% of medical and productivity costs attributable to CVD. CONCLUSIONS:The burden of informal caregiving for patients with CVD is significant; accounting for these costs increases total CVD costs to $616 billion in 2015 and $1.2 trillion in 2035. These estimates have important research and policy implications, and they may be used to guide policy development to reduce the burden of CVD on patients and their caregivers.

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Symptom Burden, Depression, and Spiritual Well-Being: A Comparison of Heart Failure and Advanced Cancer Patients

Cited by 244 publications

References 67 publications

Measuring Depressive Symptoms in Heart Failure: Validity and Reliability of the Patient Health Questionnaire-8

Measuring Depressive Symptoms in Heart Failure: Validity and Reliability of the Patient Health Questionnaire-8

Translating and Testing the ENABLE: CHF-PC Concurrent Palliative Care Model for Older Adults with Heart Failure and Their Family Caregivers

Projected Costs of Informal Caregiving for Cardiovascular Disease: 2015 to 2035: A Policy Statement From the American Heart Association

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