title: Caregiver burden, productivity loss, and indirect costs associated with caring for patients with poststroke spasticity.
abstract: OBJECTIVE
  Many stroke survivors experience poststroke spasticity and the related inability to perform basic activities, which necessitates patient management and treatment, and exerts a considerable burden on the informal caregiver. The current study aims to estimate burden, productivity loss, and indirect costs for caregivers of stroke survivors with spasticity.
  
  
  METHODS
  Internet survey data were collected from 153 caregivers of stroke survivors with spasticity including caregiving time and difficulty (Oberst Caregiver Burden Scale), Work Productivity and Activity Impairment measures, and caregiver and patient characteristics. Fractional logit models examined predictors of work-related restriction, and work losses were monetized (2012 median US wages).
  
  
  RESULTS
  Mean Oberst Caregiver Burden Scale time and difficulty scores were 46.1 and 32.4, respectively. Employed caregivers (n=71) had overall work restriction (32%), absenteeism (9%), and presenteeism (27%). Caregiver characteristics, lack of nursing home coverage, and stroke survivors' disability predicted all work restriction outcomes. The mean total lost-productivity cost per employed caregiver was US$835 per month (>$10,000 per year; 72% attributable to presenteeism).
  
  
  CONCLUSIONS
  These findings demonstrate the substantial burden of caring for stroke survivors with spasticity illustrating the societal and economic impact of stroke that extends beyond the stroke survivor.
authors.affiliation: Allergan, Irvine, CA, USA.
authors.forename: Vaidyanathan
authors.initials: V
authors.lastname: Ganapathy
authors.affiliation: Department of Veterans Affairs, San Francisco, CA, USA.
authors.forename: Glenn D
authors.initials: GD
authors.lastname: Graham
authors.affiliation: Health Outcomes Practice, Kantar Health, New York, NY, USA.
authors.forename: Marco D
authors.initials: MD
authors.lastname: DiBonaventura
authors.affiliation: Allergan, Irvine, CA, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Gillard
authors.affiliation: Health Outcomes Practice, Kantar Health, New York, NY, USA.
authors.forename: Amir
authors.initials: A
authors.lastname: Goren
authors.affiliation: Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Zorowitz
mesh_terms: D000041:Absenteeism; D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data*; D017281:Cost of Illness; D004526:Efficiency; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology*; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000150:complications*; D013997:Time Factors
keywords: burden; caregiver; productivity; spasticity; stroke