Abstract 4338185: Is the Benefit of a Supportive Intervention for Heart Failure Caregivers Sustained Over Time?

Abstract

Background: Caregiving is stressful, and caregivers commonly neglect self-care. We tested the effectiveness of virtual health coaching and demonstrated at 6 months that self-care, stress, and mental health-related quality of life (HRQL) improved significantly more in HF caregivers in the intervention group vs the control group. Objective: To determine if the benefits of health coaching on self-care, stress, and HRQL were sustained at 12 months. Method: Informal caregivers (N=250) were randomly assigned to receive virtual health coaching and health information or a control group receiving only health information. Caregivers in the intervention received ≤10 sessions of individual synchronous virtual health coaching promoting self-care. The primary outcome was self-care (Self-Care Inventory), secondary outcomes were stress (Perceived Stress Scale), mental and physical HRQL (SF-36). In this analysis of sustained effects, linear mixed effects models were used to estimate between-group differences in change from baseline to 12 months and 6 to 12 months, the post-intervention interval. Change in the intervention group from 6 to 12 months was also analyzed. Statistically significant effect sizes are reported. Results: When analyzing the change in self-care between groups, we found no significant intervention effect from baseline to 12 months (p=0.28) nor from 6 to 12 months (p=0.08). Self-care did not change significantly in the intervention group from 6 to 12 months (p=0.13). Compared to controls, the intervention group had a significantly greater mean decrease in stress from baseline to 12 months (M=-2.64, 95% CI [-4.82,-0.46], p=0.02), though not from 6 to 12 months (p=0.11). Stress did not change significantly in the intervention group from 6 to 12 months (p=0.45). We found no significant difference in the change in physical HRQL between groups from baseline to 12 months (p=0.42) nor from 6 to 12 months (p=0.052). However, physical HRQL increased significantly in the intervention group from 6 to 12 months (M=1.44,95% CI [0.02,2.85], p=0.047). Mental HRQL improvement did not differ significantly between treatment and control groups from baseline to 12 months (p=0.64) nor from 6 to 12 months (p=0.08). Mental HRQL did not improve significantly in the intervention group from 6 to 12 months (p=0.36). Conclusions: In informal HF caregivers, virtual health coaching led to sustained benefits in stress and physical HRQL, even 6 months after health coaching ended.