Abstract 4140518: LVAD Recipients and Caregivers Expectations for Communication

Introduction: Effective communication strategies regarding illness trajectory with left ventricular assist device (LVAD) recipients and their caregivers are lacking. This study evaluated LVAD recipients and caregivers’ preferences for effective communication surrounding end of life care and risk of complications. Methods: We conducted a qualitative study using semi-structured interviews with 9 LVAD recipients and 9 caregivers between 4/1/2024 – 5/6/2024. Interviews were transcribed and coded, with themes identified using rapid qualitative analysis. Results: Included patients had a median age (range) of 65 (24-81) years, 6 (67%) were men, 5 (56%) were White and 5 (56%) received their LVAD as destination therapy (DT). Participating caregivers included 8 (89%) women supporting 5 (56%) DT LVAD recipients. When asked about ways to improve communication regarding illness trajectory with a LVAD, majority of patients and caregivers desired to have communication prior to LVAD placement and favored learning about survival, risk of complications, quality of life with an LVAD. They favored precise estimates of associated risks and survival rather than general outcomes. Additionally, majority of patients and caregivers preferred healthcare providers initiate end of life discussions, with caregivers present in a clinic visit. We identified three themes explaining patients and caregivers’ preference for improved communication for LVAD (i) direct and honest communication (ii) caregiver or care partner as an advocate and (iii) type of information desired. Exemplary quotes highlighting these themes are provided in the Table below. Conclusion: Our qualitative study highlights patients and caregivers’ preference for communication surrounding LVAD prognosis, risk, and end of life discussions. This highlights areas of improvement regarding LVAD communication.