Caregiver Well-being and Patient Outcomes in Heart Failure: A Meta-analysis.

The included studies were observational and measured relationships at a single time point, so they cannot show whether caregiver strain causes worse patient outcomes or whether worse patient outcomes cause caregiver strain. Patient heart failure symptoms were often measured only by NYHA Class, a broad severity category, so more specific symptom burden may be missed. Several analyses had few studies, including only 2 studies for strain and quality of life. Clinical event outcomes varied too much in definition and time period to combine into a single summary effect. The literature often measured patients and caregivers separately rather than studying the relationship between them. The authors searched only English-language studies, so relevant non-English work may have been missed.

The authors declared no conflicts of interest.

Do not read these associations as proof that reducing caregiver strain improves patient outcomes. The included studies were observational and cross-sectional, so the direction of influence is not established, and clinical event relationships could not be pooled.