BACKGROUND:Heart failure (HF) self-care interventions can improve outcomes, but less than optimal adherence may limit their effectiveness. We evaluated if adherence to weight monitoring and diuretic self-adjustment was associated with HF-related emergency department (ED) visits or hospitalizations. METHODS AND RESULTS: We performed a case-control analysis nested in a HF self-care randomized trial. Participants received HF self-care training, including weight monitoring and diuretic self-adjustment, which they were to record in a diary. We defined case time periods as HF-related ED visits or hospitalizations in the 7 preceding days; control time periods were defined as 7-day periods free of ED visits and hospitalizations. We used logistic regression to compare weight monitoring and diuretic self-adjustment adherence in case and control time periods, adjusted for demographic and clinical covariates. Among 303 participants, we identified 81 HF-related ED visits or hospitalizations (cases) in 54 patients over 1 year of follow-up. Weight monitoring adherence (odds ratio [OR] 0.42, 95% confidence interval [CI] 0.23-0.76) and diuretic self-adjustment adherence (OR 0.44, 95% CI 0.19-0.98) were both associated with lower adjusted odds of HF-related ED visits or hospitalizations. CONCLUSIONS: Adherence to weight monitoring and diuretic self-adjustment was associated with lower odds of HF-related ED visits or hospitalizations. Adherence to these activities may reduce HF-related morbidity.
RCT Entities:
BACKGROUND:Heart failure (HF) self-care interventions can improve outcomes, but less than optimal adherence may limit their effectiveness. We evaluated if adherence to weight monitoring and diuretic self-adjustment was associated with HF-related emergency department (ED) visits or hospitalizations. METHODS AND RESULTS: We performed a case-control analysis nested in a HF self-care randomized trial. Participants received HF self-care training, including weight monitoring and diuretic self-adjustment, which they were to record in a diary. We defined case time periods as HF-related ED visits or hospitalizations in the 7 preceding days; control time periods were defined as 7-day periods free of ED visits and hospitalizations. We used logistic regression to compare weight monitoring and diuretic self-adjustment adherence in case and control time periods, adjusted for demographic and clinical covariates. Among 303 participants, we identified 81 HF-related ED visits or hospitalizations (cases) in 54 patients over 1 year of follow-up. Weight monitoring adherence (odds ratio [OR] 0.42, 95% confidence interval [CI] 0.23-0.76) and diuretic self-adjustment adherence (OR 0.44, 95% CI 0.19-0.98) were both associated with lower adjusted odds of HF-related ED visits or hospitalizations. CONCLUSIONS: Adherence to weight monitoring and diuretic self-adjustment was associated with lower odds of HF-related ED visits or hospitalizations. Adherence to these activities may reduce HF-related morbidity.
Authors: Sharon Ann Hunt; William T Abraham; Marshall H Chin; Arthur M Feldman; Gary S Francis; Theodore G Ganiats; Mariell Jessup; Marvin A Konstam; Donna M Mancini; Keith Michl; John A Oates; Peter S Rahko; Marc A Silver; Lynne Warner Stevenson; Clyde W Yancy; Elliott M Antman; Sidney C Smith; Cynthia D Adams; Jeffrey L Anderson; David P Faxon; Valentin Fuster; Jonathan L Halperin; Loren F Hiratzka; Alice K Jacobs; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel Journal: Circulation Date: 2005-09-13 Impact factor: 29.690
Authors: Autumn Dawn Galbreath; Richard A Krasuski; Brad Smith; Karl C Stajduhar; Michael D Kwan; Robert Ellis; Gregory L Freeman Journal: Circulation Date: 2004-11-07 Impact factor: 29.690
Authors: John G F Cleland; Amala A Louis; Alan S Rigby; Uwe Janssens; Aggie H M M Balk Journal: J Am Coll Cardiol Date: 2005-04-22 Impact factor: 24.094
Authors: S P Wright; H Walsh; K M Ingley; S A Muncaster; G D Gamble; A Pearl; G A Whalley; N Sharpe; R N Doughty Journal: Eur J Heart Fail Date: 2003-06 Impact factor: 15.534
Authors: Lee R Goldberg; John D Piette; Mary Norine Walsh; Theodore A Frank; Brian E Jaski; Andrew L Smith; Raymond Rodriguez; Donna M Mancini; Laurie A Hopton; E John Orav; Evan Loh Journal: Am Heart J Date: 2003-10 Impact factor: 4.749
Authors: Christine D Jones; George M Holmes; Darren A DeWalt; Brian Erman; Jia-Rong Wu; Crystal W Cene; David W Baker; Dean Schillinger; Bernice Ruo; Kirsten Bibbins-Domingo; Aurelia Macabasco-O'Connell; Victoria Hawk; Kimberly Broucksou; Michael Pignone Journal: BMC Cardiovasc Disord Date: 2014-01-31 Impact factor: 2.298