P3792 - Prognostic Communication, Psychological Distress, and Caregiving Burden Among Caregivers of Patients With Decompensated Cirrhosis

Lucinda Li, BA¹, John Donlan, MD², Lina Nurhussien, MPH³, Nora Horick, MS³, Chengbo Zeng, PhD⁴, Teresa Indriolo, BA⁵, Malia Armstrong, BA², Grace Bizup, BA², Anushka Dalvi, BS², Enya Zhu, BA⁶, Michelle S. Diop, MD², Nancy Mason, CNP², Kirsten G. Engel, MD², Michaela Rowland, NP², Sara Kenimer, CNP², Karen O'Brien, MD², Annie Liu, DO, MS, MPH⁷, Hermioni Amonoo, MD, MPH⁴, Deborah Forst, MD², Lara Traeger, PhD⁸, Jamie M.. Jacobs, PhD², Vicki Jackson, MD, MPH², Raymond Chung, MD², Areej El-Jawahri, MD², Nneka Ufere, MD, MSCE²
1David Geffen School of Medicine at UCLA, Los Angeles, CA; 2Massachusetts General Hospital, Boston, MA; 3Massachusetts General Hospital, Somerville, MA; 4Brigham and Women's Hospital, Boston, MA; 5Stanford University School of Medicine, Palo Alto, CA; 6Duke University School of Medicine, Durham, NC; 7Massachusetts General Hospital, Harvard Medical School, Boston, MA; 8University of Miami, Miami, FL

Introduction: Caregivers play a critical role in supporting patients with decompensated cirrhosis (DC) while often also enduring psychological distress themselves. Despite caregivers essential role in medical decision-making, no studies have examined the associations of caregiver-hepatologist prognostic communication with caregivers’ psychological outcomes.

Methods: In this cross-sectional study, we examined associations of caregivers’ self-reported frequency, adequacy, and quality of prognostic communication from the patient’s hepatologist (Prognosis and Treatment Preferences Questionnaire) with their anxiety and depression symptoms (Hospital Anxiety and Depression Scale, HADS) and caregiving burden (Zarit Burden Index-12, ZBI-12) using linear regression adjusted for caregiver age, gender, and relationship to the patient.

Results: Between 8/2018-9/2022, we enrolled 127/162 (78%) adult caregivers of patients with DC (median age 59, 62% female, 63% spouses). In total, 52% and 35% of caregivers reported clinically significant anxiety and depression symptoms (HADS subscale ≥8), and 27% reported high caregiving burden (ZBI-12 >20). Over 85% had never participated in prognostic communication about the patients’ end-of-life care preferences with their hepatologist. High frequency of prognostic communication with the patient’s hepatologist was associated with lower caregiving burden (β=-4.82, p=0.01). Receipt of adequate information about the patient’s prognosis was associated with lower caregiving burden (β=-4.21, p=0.02). Lastly, rating as high-quality the prognostic communication from the patient’s hepatologist was associated with lower caregiver anxiety symptoms (β=-2.31, p=0.03). Frequency and adequacy of prognostic communication were not significantly associated with caregivers’ anxiety and depression symptoms. Quality of prognostic communication was not significantly associated with caregiving burden or depression symptoms.

Discussion: These findings highlight the substantial psychological distress and burden experienced by caregivers of patients with DC and highlight prognostic understanding as a potential modifiable target for improving their psychological outcomes.

Disclosures:
Lucinda Li indicated no relevant financial relationships.
John Donlan indicated no relevant financial relationships.
Lina Nurhussien indicated no relevant financial relationships.
Nora Horick indicated no relevant financial relationships.
Chengbo Zeng indicated no relevant financial relationships.
Teresa Indriolo indicated no relevant financial relationships.
Malia Armstrong indicated no relevant financial relationships.
Grace Bizup indicated no relevant financial relationships.
Anushka Dalvi indicated no relevant financial relationships.
Enya Zhu indicated no relevant financial relationships.
Michelle Diop indicated no relevant financial relationships.
Nancy Mason indicated no relevant financial relationships.
Kirsten Engel indicated no relevant financial relationships.
Michaela Rowland indicated no relevant financial relationships.
Sara Kenimer indicated no relevant financial relationships.
Karen O'Brien indicated no relevant financial relationships.
Annie Liu indicated no relevant financial relationships.
Hermioni Amonoo indicated no relevant financial relationships.
Deborah Forst: Eli Lilly – Stock-publicly held company(excluding mutual/index funds).
Lara Traeger indicated no relevant financial relationships.
Jamie Jacobs: OncoveryCare, Inc – Consultant. Reunion Neuroscience, Inc. – Consultant.
Vicki Jackson: Tuesday Health – Consultant.
Raymond Chung indicated no relevant financial relationships.
Areej El-Jawahri indicated no relevant financial relationships.
Nneka Ufere indicated no relevant financial relationships.

Lucinda Li, BA¹, John Donlan, MD², Lina Nurhussien, MPH³, Nora Horick, MS³, Chengbo Zeng, PhD⁴, Teresa Indriolo, BA⁵, Malia Armstrong, BA², Grace Bizup, BA², Anushka Dalvi, BS², Enya Zhu, BA⁶, Michelle S. Diop, MD², Nancy Mason, CNP², Kirsten G. Engel, MD², Michaela Rowland, NP², Sara Kenimer, CNP², Karen O'Brien, MD², Annie Liu, DO, MS, MPH⁷, Hermioni Amonoo, MD, MPH⁴, Deborah Forst, MD², Lara Traeger, PhD⁸, Jamie M.. Jacobs, PhD², Vicki Jackson, MD, MPH², Raymond Chung, MD², Areej El-Jawahri, MD², Nneka Ufere, MD, MSCE². P3792 - Prognostic Communication, Psychological Distress, and Caregiving Burden Among Caregivers of Patients With Decompensated Cirrhosis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.