Sandra B Dunbar1, Patricia C Clark2, Carolyn M Reilly3, Rebecca A Gary3, Andrew Smith4, Frances McCarty5, Melinda Higgins3, Daurice Grossniklaus3, Nadine Kaslow4, Jennifer Frediani4, Carolyn Dashiff6, Richard Ryan7. 1. Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia; School of Medicine, Emory University, Atlanta, Georgia. Electronic address: sbdunba@emory.edu. 2. Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, Atlanta, Georgia. 3. Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia. 4. School of Medicine, Emory University, Atlanta, Georgia. 5. School of Public Health, Emory University, Atlanta, Georgia. 6. College of Nursing, University of Alabama, Birmingham, Alabama. 7. Department of Psychology, University of Rochester, Rochester, New York.
Abstract
BACKGROUND: Lowering dietary sodium and adhering to medication regimens are difficult for persons with heart failure (HF). Because these behaviors often occur within the family context, this study evaluated the effects of family education and partnership interventions on dietary sodium (Na) intake and medication adherence (MA). METHODS AND RESULTS: HF patient and family member (FM) dyads (n = 117) were randomized to: usual care (UC), patient-FM education (PFE), or family partnership intervention (FPI). Dietary Na (3-day food record), urinary Na (24-hour urine), and MA (Medication Events Monitoring System) were measured at baseline (BL) before randomization, and at 4 and 8 months. FPI and PFE reduced urinary Na at 4 months, and FPI differed from UC at 8 months (P = .016). Dietary Na decreased from BL to 4 months, with both PFE (P = .04) and FPI (P = .018) lower than UC. The proportion of subjects adherent to Na intake (≤2,500 mg/d) was higher at 8 months in PFE and FPI than in UC (χ(2)(2) = 7.076; P = .029). MA did not differ among groups across time. Both FPI and PFE groups increased HF knowledge immediately after intervention. CONCLUSIONS: Dietary Na intake, but not MA, was improved by PFE and FPI compared with UC. The UC group was less likely to be adherent with dietary Na. Greater efforts to study and incorporate family-focused education and support interventions into HF care are warranted.
RCT Entities:
BACKGROUND: Lowering dietary sodium and adhering to medication regimens are difficult for persons with heart failure (HF). Because these behaviors often occur within the family context, this study evaluated the effects of family education and partnership interventions on dietary sodium (Na) intake and medication adherence (MA). METHODS AND RESULTS: HF patient and family member (FM) dyads (n = 117) were randomized to: usual care (UC), patient-FM education (PFE), or family partnership intervention (FPI). Dietary Na (3-day food record), urinary Na (24-hour urine), and MA (Medication Events Monitoring System) were measured at baseline (BL) before randomization, and at 4 and 8 months. FPI and PFE reduced urinary Na at 4 months, and FPI differed from UC at 8 months (P = .016). Dietary Na decreased from BL to 4 months, with both PFE (P = .04) and FPI (P = .018) lower than UC. The proportion of subjects adherent to Na intake (≤2,500 mg/d) was higher at 8 months in PFE and FPI than in UC (χ(2)(2) = 7.076; P = .029). MA did not differ among groups across time. Both FPI and PFE groups increased HF knowledge immediately after intervention. CONCLUSIONS: Dietary Na intake, but not MA, was improved by PFE and FPI compared with UC. The UC group was less likely to be adherent with dietary Na. Greater efforts to study and incorporate family-focused education and support interventions into HF care are warranted.
Authors: Jia-Rong Wu; Debra K Moser; Marla J De Jong; Mary Kay Rayens; Misook L Chung; Barbara Riegel; Terry A Lennie Journal: Am Heart J Date: 2008-12-24 Impact factor: 4.749
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