Key result
Improved HF caregiver self-care linked to a ~67% decrease in patient hospitalizations.
Why the study?
Health coaching reduces HF caregiver stress and increases self-care, but the downstream effects of caregiver self-care improvements on HF patient hospitalization outcomes remain unexamined.
Does improvement in caregiver self-care reduce patient hospitalizations in heart failure patient-caregiver dyads?
RCT (n=125)
Does improvement in caregiver self-care reduce patient hospitalizations in heart failure patient-caregiver dyads?
Effect estimate: IRR 0.332 (95% CI 0.131-0.841)
p-value: p=0.02
Improvement in heart failure caregiver self-care is associated with a significant reduction in patient hospitalizations, highlighting the clinical value of supporting caregiver health.
Supporting HF caregiver self-care may reduce hospitalizations; extends dyadic evidence but leaves open causality pending RCTs.
Abstract Background Health coaching has been shown to reduce heart failure (HF) caregiver stress and increase caregiver engagement in healthy lifestyle behaviors ("self-care"). The objective of this study was to examine potential downstream effects of improvements in self-care of the caregiver on HF patient hospitalization outcomes. Methods and Results Data were from a randomized controlled trial testing the efficacy of a health coaching intervention versus information-only control on HF caregiver self-care. Self-care of the caregiver was measured using the Self-Care Inventory. Care recipient hospitalizations and hospitalization days were abstracted from the medical record. Zero-inflated negative binomial models were used to assess the extent to which caregiver self-care improvement, of any degree and regardless of intervention condition, was predictive of patient hospitalization and hospitalization days, adjusting for common confounders. The sample included 125 HF patient-caregiver dyads from both groups, 61.6% of which were spousal/partnered. Nearly two-thirds (62.4%) of caregivers demonstrated self-care improvement. Approximately a quarter (25.6%) of patients experienced at least one hospitalization. Adjusting for confounders, patients with caregivers who improved in self-care experienced significantly fewer hospitalizations (IRR 0.332, 95% CI 0.131, 0.841, p=0.02). No significant effect was observed for hospital days (IRR 0.773, 95% CI 0.271, 2.206). Conclusions Improvement in HF caregiver self-care was associated with a 67% decrease in patient hospitalizations. Our findings support additional investment in research, programs, and policies that support caregiver health. Our findings may also reassure caregivers, patients, and clinicians that investing time in supporting caregiver health is time well spent and may have potential benefits for patient outcomes. Trial registration ClinicalTrials.gov, [NCT number blinded for review]
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Bidwell et al. (2026) conducted an RCT in Heart failure (n=125). Health coaching intervention vs. Information-only control was evaluated on Patient hospitalizations (IRR 0.332, 95% CI 0.131-0.841, p=0.02). Improvement in heart failure caregiver self-care was associated with a 67% decrease in patient hospitalizations (IRR 0.332; 95% CI 0.131-0.841; p=0.02).
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