Family Cardiac Caregiver Investigation to Evaluate Outcomes

New approaches to implement proven preventive and lifestyle interventions are needed to
reach the NHLBI strategic plan goal to speed the translation of science into practice and
reduce the public health burden of cardiovascular disease (CVD). It has been established
that cardiac caregivers are a vehicle by which health information can be transmitted, and
that caregivers themselves may be at increased CVD risk. Our research will evaluate the
potential pool and demographic profile of cardiac caregivers as well as the role(s) they
play in improving quality of patient care and to enhance adherence to secondary prevention
guidelines post discharge. This research will also provide important information about
targeting educational efforts to specific caregivers to enhance the clinical outcomes of
hospitalized coronary patients. The purpose of this study is to estimate the prevalence of
caregiving in hospitalized cardiac patients by demographic factors such as patient age and
race/ethnicity, and to link caregiving to clinical outcomes in cardiac patients. A
secondary aim is to collect family tree data which will allow us to estimate the number of
first degree family members, their basic demographics, and the distance at which they live
from the medical center in order to determine the feasibility and scope of a targeted
preventive intervention. The specific aims are to determine: 1) the prevalence and
demographic characteristics of primary cardiac caregivers among all Cardiac Service Line
inpatients during a consecutive 6 month period at a major academic teaching hospital, 2) the
relation between having or not having a cardiac caregiver and patient clinical outcomes
(including CVD morbidity, mortality, and rehospitalizations)and adherence to medications at
30 days post hospital discharge adjusted for patient demographic characteristics, admitting
diagnoses, and co-morbidities, 3) feasibility of an extended family-centered educational and
behavioral intervention that will include an outreach to family members of patients
hospitalized with CVD to ensure appropriate screening, lifestyle education, and referral of
family members for evidence-based risk reduction therapies when appropriate. The
significance of this research is that it addresses specific challenges outlined in the
recent NHLBI strategic plan to develop and evaluate programs to improve patient, provider,
and health care system behavior and performance to enhance quality of care and health
outcomes, especially in populations that experience a disproportionate disease burden.
Unique information will be obtained about caregivers as a potential intervention to improve
preventive care and health outcomes of patients and families that suffer disproportionate
CVD burden. Improved adherence to evidence-based preventive therapies could have a
substantial public health benefit.