Clinicians for CARE: A Systematic Review and Meta‐Analysis of Interventions to Support Caregivers of Patients With Heart Disease
Background Caregivers provide critical support for patients with chronic diseases, including heart disease, but often experience caregiver stress that negatively impacts their health, quality of life, and patient outcomes. We aimed to inform health care teams on an evidence‐based approach to support...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.019706 |
| _version_ | 1797945419658952704 |
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| author | Kellen A. Knowles Helen Xun Sunyoung Jang Sharon Pang Charles Ng Apurva Sharma Erin M. Spaulding Rohanit Singh Alaa Diab Ngozi Osuji Joshua Materi Danielle Amundsen Shannon Wongvibulsin Daniel Weng Pauline Huynh Julie Nanavati Jennifer Wolff Francoise A. Marvel Seth S. Martin |
| author_facet | Kellen A. Knowles Helen Xun Sunyoung Jang Sharon Pang Charles Ng Apurva Sharma Erin M. Spaulding Rohanit Singh Alaa Diab Ngozi Osuji Joshua Materi Danielle Amundsen Shannon Wongvibulsin Daniel Weng Pauline Huynh Julie Nanavati Jennifer Wolff Francoise A. Marvel Seth S. Martin |
| author_sort | Kellen A. Knowles |
| collection | DOAJ |
| description | Background Caregivers provide critical support for patients with chronic diseases, including heart disease, but often experience caregiver stress that negatively impacts their health, quality of life, and patient outcomes. We aimed to inform health care teams on an evidence‐based approach to supporting the caregivers of patients with heart disease. Methods and Results We conducted a systematic review and meta‐analysis of randomized controlled trials written in English that evaluated interventions to support caregivers of patients with heart disease. We identified 15,561 articles as of April 2, 2020 from 6 databases; of which 20 unique randomized controlled trials were evaluated, representing a total of 1570 patients and 1776 caregivers. Most interventions focused on improving quality of life, and reducing burden, depression, and anxiety; 85% (17 of 20) of the randomized controlled trials provided psychoeducation for caregivers. Interventions had mixed results, with moderate non‐significant effects observed for depression (Hedges’ g=−0.64; 95% CI, −1.34 to 0.06) and burden (Hedges’ g=−0.51; 95% CI, −2.71 to 1.70) at 2 to 4 months postintervention and small non‐significant effects observed for quality of life and anxiety. These results were limited by the heterogeneity of outcome measures and intervention delivery methods. A qualitative synthesis of major themes of the interventions resulted in clinical recommendations represented with the acronym “CARE” (Caregiver‐Centered, Active engagement, Reinforcement, Education). Conclusions This systematic review highlights the need for greater understanding of the challenges faced by caregivers and the development of guidelines to help clinicians address those challenges. More research is necessary to develop clinical interventions that consistently improve caregiver outcomes. |
| first_indexed | 2024-04-10T20:54:51Z |
| format | Article |
| id | doaj.art-a1f0f98b303e4a47a2c035270ce968f7 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T20:54:51Z |
| publishDate | 2021-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-a1f0f98b303e4a47a2c035270ce968f72023-01-23T07:23:58ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-12-01102410.1161/JAHA.120.019706Clinicians for CARE: A Systematic Review and Meta‐Analysis of Interventions to Support Caregivers of Patients With Heart DiseaseKellen A. Knowles0Helen Xun1Sunyoung Jang2Sharon Pang3Charles Ng4Apurva Sharma5Erin M. Spaulding6Rohanit Singh7Alaa Diab8Ngozi Osuji9Joshua Materi10Danielle Amundsen11Shannon Wongvibulsin12Daniel Weng13Pauline Huynh14Julie Nanavati15Jennifer Wolff16Francoise A. Marvel17Seth S. Martin18Johns Hopkins Bayview Medical Center Baltimore MDJohns Hopkins University School of Medicine Baltimore MDJohns Hopkins University School of Medicine Baltimore MDJohns Hopkins University School of Medicine Baltimore MDJohns Hopkins Bloomberg School of Public Health Baltimore MDDivision of Cardiology Department of Medicine Johns Hopkins University School of Medicine Baltimore MDJohns Hopkins Bloomberg School of Public Health Baltimore MDJohns Hopkins University School of Medicine Baltimore MDSt George’s University of London Medical School London United KingdomDivision of Cardiology Department of Medicine Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins University School of Medicine Baltimore MDJohns Hopkins University School of Medicine Baltimore MDJohns Hopkins University School of Medicine Baltimore MDJohns Hopkins University School of Medicine Baltimore MDJohns Hopkins University School of Medicine Baltimore MDJohns Hopkins University School of Medicine Baltimore MDJohns Hopkins University School of Medicine Baltimore MDJohns Hopkins Bloomberg School of Public Health Baltimore MDDivision of Cardiology Department of Medicine Johns Hopkins University School of Medicine Baltimore MDDivision of Cardiology Department of Medicine Johns Hopkins University School of Medicine Baltimore MDBackground Caregivers provide critical support for patients with chronic diseases, including heart disease, but often experience caregiver stress that negatively impacts their health, quality of life, and patient outcomes. We aimed to inform health care teams on an evidence‐based approach to supporting the caregivers of patients with heart disease. Methods and Results We conducted a systematic review and meta‐analysis of randomized controlled trials written in English that evaluated interventions to support caregivers of patients with heart disease. We identified 15,561 articles as of April 2, 2020 from 6 databases; of which 20 unique randomized controlled trials were evaluated, representing a total of 1570 patients and 1776 caregivers. Most interventions focused on improving quality of life, and reducing burden, depression, and anxiety; 85% (17 of 20) of the randomized controlled trials provided psychoeducation for caregivers. Interventions had mixed results, with moderate non‐significant effects observed for depression (Hedges’ g=−0.64; 95% CI, −1.34 to 0.06) and burden (Hedges’ g=−0.51; 95% CI, −2.71 to 1.70) at 2 to 4 months postintervention and small non‐significant effects observed for quality of life and anxiety. These results were limited by the heterogeneity of outcome measures and intervention delivery methods. A qualitative synthesis of major themes of the interventions resulted in clinical recommendations represented with the acronym “CARE” (Caregiver‐Centered, Active engagement, Reinforcement, Education). Conclusions This systematic review highlights the need for greater understanding of the challenges faced by caregivers and the development of guidelines to help clinicians address those challenges. More research is necessary to develop clinical interventions that consistently improve caregiver outcomes.https://www.ahajournals.org/doi/10.1161/JAHA.120.019706anxietyburdencardiovascular diseasecaregiverdepressionheart disease |
| spellingShingle | Kellen A. Knowles Helen Xun Sunyoung Jang Sharon Pang Charles Ng Apurva Sharma Erin M. Spaulding Rohanit Singh Alaa Diab Ngozi Osuji Joshua Materi Danielle Amundsen Shannon Wongvibulsin Daniel Weng Pauline Huynh Julie Nanavati Jennifer Wolff Francoise A. Marvel Seth S. Martin Clinicians for CARE: A Systematic Review and Meta‐Analysis of Interventions to Support Caregivers of Patients With Heart Disease Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease anxiety burden cardiovascular disease caregiver depression heart disease |
| title | Clinicians for CARE: A Systematic Review and Meta‐Analysis of Interventions to Support Caregivers of Patients With Heart Disease |
| title_full | Clinicians for CARE: A Systematic Review and Meta‐Analysis of Interventions to Support Caregivers of Patients With Heart Disease |
| title_fullStr | Clinicians for CARE: A Systematic Review and Meta‐Analysis of Interventions to Support Caregivers of Patients With Heart Disease |
| title_full_unstemmed | Clinicians for CARE: A Systematic Review and Meta‐Analysis of Interventions to Support Caregivers of Patients With Heart Disease |
| title_short | Clinicians for CARE: A Systematic Review and Meta‐Analysis of Interventions to Support Caregivers of Patients With Heart Disease |
| title_sort | clinicians for care a systematic review and meta analysis of interventions to support caregivers of patients with heart disease |
| topic | anxiety burden cardiovascular disease caregiver depression heart disease |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.019706 |
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