42 - Caregivers of Waitlisted Liver Transplant Candidates Experience Significant Financial Burden and Psychological Symptoms

Meena M. Tadros, BS¹, Alvaro Noriega Ramirez, BS¹, Dyanna Gregory, MS¹, Nneka Ufere, MD, MSCE², Jeremy Louissaint, MD¹, Thomas G. Cotter, MD¹, Nicole E. Rich, MD, MSCS¹, Arjmand R. Mufti, MD¹, Lisa B. VanWagner, MD, MSCI¹, Amit G. Singal, MD, MS¹, Sarah R. Lieber, MD, MSCR^1
1UT Southwestern Medical Center, Dallas, TX; ²Massachusetts General Hospital, Harvard Medical School, Boston, MA

Introduction: Individuals requiring liver transplantation (LT) rely heavily on caregivers. Despite the pivotal role caregivers play, their experiences remain poorly understood. We aimed to describe patient-reported outcomes (PROs) including caregiver burden and financial distress among LT caregivers, and to identify any discordant experiences between caregivers and candidates.

Methods: Caregivers and waitlisted LT candidate dyads were assessed at a large academic transplant center. Sociodemographic characteristics and PROs were evaluated using the Preparedness for Caregiving Scale, Zarit Burden Interview-12, COST-FACIT financial burden (higher scores indicating better financial status), support, social isolation, depression, and anxiety assessed by PROMIS measures. In addition to descriptive statistics, bivariate analyses compared sociodemographic characteristics and caregiver PROs, as well as scores between caregivers and LT listed dyads.

Results: Among 33 caregivers, a majority were female (82%), White (91%), and spouses/partners (64%) of LT candidates (Table 1). One-third (34.4%) identified as Hispanic; 42% had less than or equivalent to a high school education, and 26.7% reported an annual income < $25,000. Mean COST-FACIT scores were 23.5 (SD 9.3) and 20% reported “quite a bit” or “very much” financial hardship. Half of caregivers reported “moderate” (33%) to “high” (17%) caregiver burden, and 18% reported transportation issues. Compared to national T score averages reported by PROMIS, caregivers had higher PROMIS anxiety and depression scores at baseline. Higher caregiver education was significantly associated with higher informational support (i.e., factual knowledge) (p=0.03); higher income ( >$75K) was significantly associated with lower financial burden (p=0.01). Compared to LT candidates, caregivers reported significantly higher emotional support (p=0.004); all other PROs were concordant among caregivers and LT candidates.

Discussion: Preliminary data show that 1 in 5 caregivers experience significant financial hardship with low/moderate scores of financial well-being. Half of caregivers experience moderate to high caregiver burden, and overall have higher anxiety and depression compared to national estimates. Caregiver experiences will be assessed longitudinally to better characterize financial and psychological burden over time, and to inform tailored interventions that may mitigate these potential harms.



Disclosures:


Meena M. Tadros, BS¹, Alvaro Noriega Ramirez, BS¹, Dyanna Gregory, MS¹, Nneka Ufere, MD, MSCE², Jeremy Louissaint, MD¹, Thomas G. Cotter, MD¹, Nicole E. Rich, MD, MSCS¹, Arjmand R. Mufti, MD¹, Lisa B. VanWagner, MD, MSCI¹, Amit G. Singal, MD, MS¹, Sarah R. Lieber, MD, MSCR¹, 42, Caregivers of Waitlisted Liver Transplant Candidates Experience Significant Financial Burden and Psychological Symptoms, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.