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<p>Left ventricular assist device (LVAD) therapy requires safe long-term home management supported by patients, caregivers, and healthcare systems. In Japan, continuous caregiver availability was historically required or strongly expected in LVAD home management, although this framework has recently been relaxed. We evaluated the psychological and socioeconomic burden experienced by LVAD patients and primary caregivers under this former 24-h caregiver-accompaniment framework. This cross-sectional, nationwide anonymous web-based questionnaire survey was conducted through 79 LVAD centers between April and July 2024. De-identified individual-level data from 184 patients and 136 primary caregivers were analyzed. Prespecified comparisons of depressive symptoms according to caregiver-accompaniment burden and work/study status were performed within each respondent group, and multivariable logistic regression was used to identify factors associated with depressive symptoms. Psychological burden related to caregiver accompaniment was reported by 83.7% of patients and 61.8% of caregivers. Not working or studying was reported by 44.0% and 31.6%, respectively. Depressive symptoms were reported in 36.4% of patients and 35.3% of caregivers. Depressive symptoms were more frequent among respondents with caregiver-accompaniment burden than among those without such burden in both patients (61/154 [39.6%] vs. 6/30 [20.0%]; <i>p</i> = 0.041) and caregivers (38/84 [45.2%] vs. 10/52 [19.2%]; <i>p</i> = 0.002), whereas depressive symptoms did not differ significantly according to work/study status. Under the former 24-h caregiver-accompaniment framework, Japanese LVAD households reported substantial psychological and socioeconomic burdens. These findings provide real-world baseline data for evaluating recent policy relaxation and for designing support systems that promote quality of life and social reintegration while maintaining safety.</p>

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Psychological and socioeconomic impact of long-term home management on patients with left ventricular assist devices and their caregivers: a nationwide multicenter questionnaire survey

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  • 发表日期：

    2026年7月9日

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  • Michiko Watanabe,
  • Goro Matsumiya,
  • Hiroki Kohno,
  • Koichiro Kinugawa

摘要

Left ventricular assist device (LVAD) therapy requires safe long-term home management supported by patients, caregivers, and healthcare systems. In Japan, continuous caregiver availability was historically required or strongly expected in LVAD home management, although this framework has recently been relaxed. We evaluated the psychological and socioeconomic burden experienced by LVAD patients and primary caregivers under this former 24-h caregiver-accompaniment framework. This cross-sectional, nationwide anonymous web-based questionnaire survey was conducted through 79 LVAD centers between April and July 2024. De-identified individual-level data from 184 patients and 136 primary caregivers were analyzed. Prespecified comparisons of depressive symptoms according to caregiver-accompaniment burden and work/study status were performed within each respondent group, and multivariable logistic regression was used to identify factors associated with depressive symptoms. Psychological burden related to caregiver accompaniment was reported by 83.7% of patients and 61.8% of caregivers. Not working or studying was reported by 44.0% and 31.6%, respectively. Depressive symptoms were reported in 36.4% of patients and 35.3% of caregivers. Depressive symptoms were more frequent among respondents with caregiver-accompaniment burden than among those without such burden in both patients (61/154 [39.6%] vs. 6/30 [20.0%]; p = 0.041) and caregivers (38/84 [45.2%] vs. 10/52 [19.2%]; p = 0.002), whereas depressive symptoms did not differ significantly according to work/study status. Under the former 24-h caregiver-accompaniment framework, Japanese LVAD households reported substantial psychological and socioeconomic burdens. These findings provide real-world baseline data for evaluating recent policy relaxation and for designing support systems that promote quality of life and social reintegration while maintaining safety.