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Patterns of adherence to diuretics, dietary sodium and fluid intake recommendations in adults with heart failure.
Heart Lung. 2019 May - Jun; 48(3):179-185.HL

Abstract

BACKGROUND

Three behaviors advocated to minimize fluid-related hospitalizations in patients with heart failure (HF) are restricted sodium and fluid intake and consistent oral diuretic use. Adherence to behaviors intended to decrease risk of hospitalization is believed to vary over time, but surprisingly little research has addressed patterns of adherence in HF patients.

OBJECTIVE

To describe patterns over time of 3 recommended self-care behaviors (i.e., diet, fluid intake, and diuretic dosing) in adults with HF and to determine how time and behavior influenced adherence rates.

METHODS

We enrolled 24 adults hospitalized for a HF exacerbation and discharged on a loop diuretic into a descriptive, longitudinal pilot study. Over 3-months, diuretic use was measured using electronic event monitoring, and participants were telephoned regularly to assess sodium and fluid intake. Data were summarized for each 2-week intervals.

RESULTS

The overall adherence rates were 42.4% for low sodium diet, 96.4% for fluid restriction, and 84.7% for the diuretic regimen. Early after hospital discharge, medication adherence was the highest, and dietary adherence was the lowest, but adherence to diet and diuretic use decreased significantly over time.

CONCLUSION

Although participants were just discharged from the hospital after an acute exacerbation of HF, all three behavioral patterns decreased markedly over the 3-month follow-up period.

Links

PMC Free PDF

Authors+Show Affiliations

Riegel B
School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, 19104-4217 PA, USA. Electronic address: briegel@nursing.upenn.edu.
Lee S
School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, 19104-4217 PA, USA.
Hill J
Family Nurse Practitioner, North End Waterfront Health, Boston, MA, USA.
Daus M
School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, 19104-4217 PA, USA.
Baah FO
School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, 19104-4217 PA, USA.
Wald JW
Advanced heart failure and transplant program, university of Pennsylvania, Philadelphia, PA, USA.
Knafl GJ
School of Nursing, University of North Carolina, Chapel Hill, NC, USA.

MeSH

Diet, Sodium-RestrictedDiureticsFemaleFluid TherapyFollow-Up StudiesHeart FailureHospitalizationHumansMaleMedication AdherenceMiddle AgedPilot ProjectsPractice Guidelines as TopicSodium Chloride, Dietary

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30638609

Citation

Riegel, Barbara, et al. "Patterns of Adherence to Diuretics, Dietary Sodium and Fluid Intake Recommendations in Adults With Heart Failure." Heart & Lung : the Journal of Critical Care, vol. 48, no. 3, 2019, pp. 179-185.
Riegel B, Lee S, Hill J, et al. Patterns of adherence to diuretics, dietary sodium and fluid intake recommendations in adults with heart failure. Heart Lung. 2019;48(3):179-185.
Riegel, B., Lee, S., Hill, J., Daus, M., Baah, F. O., Wald, J. W., & Knafl, G. J. (2019). Patterns of adherence to diuretics, dietary sodium and fluid intake recommendations in adults with heart failure. Heart & Lung : the Journal of Critical Care, 48(3), 179-185. https://doi.org/10.1016/j.hrtlng.2018.12.008
Riegel B, et al. Patterns of Adherence to Diuretics, Dietary Sodium and Fluid Intake Recommendations in Adults With Heart Failure. Heart Lung. 2019 May - Jun;48(3):179-185. PubMed PMID: 30638609.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patterns of adherence to diuretics, dietary sodium and fluid intake recommendations in adults with heart failure. AU - Riegel,Barbara, AU - Lee,Solim, AU - Hill,Julia, AU - Daus,Marguerite, AU - Baah,Foster Osei, AU - Wald,Joyce W, AU - Knafl,George J, Y1 - 2019/01/09/ PY - 2018/09/29/received PY - 2018/12/20/revised PY - 2018/12/21/accepted PY - 2019/1/15/pubmed PY - 2020/3/10/medline PY - 2019/1/15/entrez KW - Heart failure KW - Medication adherence KW - Self-care KW - Signs and symptoms KW - Treatment adherence SP - 179 EP - 185 JF - Heart & lung : the journal of critical care JO - Heart Lung VL - 48 IS - 3 N2 - BACKGROUND: Three behaviors advocated to minimize fluid-related hospitalizations in patients with heart failure (HF) are restricted sodium and fluid intake and consistent oral diuretic use. Adherence to behaviors intended to decrease risk of hospitalization is believed to vary over time, but surprisingly little research has addressed patterns of adherence in HF patients. OBJECTIVE: To describe patterns over time of 3 recommended self-care behaviors (i.e., diet, fluid intake, and diuretic dosing) in adults with HF and to determine how time and behavior influenced adherence rates. METHODS: We enrolled 24 adults hospitalized for a HF exacerbation and discharged on a loop diuretic into a descriptive, longitudinal pilot study. Over 3-months, diuretic use was measured using electronic event monitoring, and participants were telephoned regularly to assess sodium and fluid intake. Data were summarized for each 2-week intervals. RESULTS: The overall adherence rates were 42.4% for low sodium diet, 96.4% for fluid restriction, and 84.7% for the diuretic regimen. Early after hospital discharge, medication adherence was the highest, and dietary adherence was the lowest, but adherence to diet and diuretic use decreased significantly over time. CONCLUSION: Although participants were just discharged from the hospital after an acute exacerbation of HF, all three behavioral patterns decreased markedly over the 3-month follow-up period. SN - 1527-3288 UR - https://www.unboundmedicine.com/medline/citation/30638609/Patterns_of_adherence_to_diuretics_dietary_sodium_and_fluid_intake_recommendations_in_adults_with_heart_failure_ DB - PRIME DP - Unbound Medicine ER -