A comparative study of fluid management education before hospital discharge

Rouse, George W.; Albert, Nancy M.; Butler, Robert S.; Morrison, Shannon L.; Forney, Jennifer; Meyer, J; Cary, Theresa; Kish, G.; Brosovich, Deborah

doi:10.1016/j.hrtlng.2015.11.003

Cited by 5 publications

(11 citation statements)

References 30 publications

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“… 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 Whereas mortality outcomes were reported in eight studies, which included a total of 5787 patients (2833 in treatment group and 2954 in the control groups). 13 , 14 , 15 , 16 , 18 , 20 , 21 , 22 The follow‐up period was at least 1 month.…”

Section: Resultsmentioning

confidence: 99%

“…The mean follow‐up period was 4.8 ± 3.1 months. The most commonly reported cardiovascular co‐morbidities in six studies 12 , 14 , 15 , 16 , 21 , 22 were hypertension (72%) and coronary artery disease in five studies 13 , 15 , 19 , 21 , 22 (52%) (Supporting Information, Table S2 ), and the most common non‐cardiac co‐morbidities were type 2 diabetes (35%) in eight studies 12 , 13 , 14 , 15 , 16 , 19 , 21 , 22 and chronic obstructive pulmonary disease (25%) in five studies 14 , 16 , 19 , 21 , 22 (Supporting Information, Table S3 ).…”

Section: Resultsmentioning

confidence: 99%

“…With regard to studies that reported HF therapies, 63% (3334/5301) were treated with beta‐blocker and an angiotensin‐converting enzyme inhibitor/angiotensin II receptor blocker (3337/5301), 12 , 13 , 14 , 15 , 16 , 17 , 19 , 21 while 19% (173/907) had an internal cardioverter defibrillator 16 , 20 , 21 , 22 and 3% (35/380) had a permanent pacemaker. 21 At admission, in studies that reported symptoms, nocturnal (54%, 2487/4626) 14 , 22 or exertional (58%, 2540/4380) 14 dyspnoea and pulmonary rales (58%, 2629/4505) 14 , 16 were the most commonly reported symptoms. The mean creatinine level was 1.42 mg/dL.…”

Section: Resultsmentioning

confidence: 99%

“…15 During post-discharge follow-up, patient education is fundamental and effective patient self-care is an important tool to guiding fluid management. In a case-control study, Rouse et al 22 demonstrated that the three main aspects of patient management (daily weight to monitor hypervolemia, fluid management by limiting sodium intake, and contact a health professional following increase in weight) can reduce emergency visits due to HF as well as all-cause office visits. 22 Sethares and Elliott 17 demonstrated that a tailored message of benefits and assessment of barriers to self-care pre-discharge and post-discharge could improve outcomes, addressing the need of effective patient education before discharge.…”

Section: Interventionsmentioning

confidence: 99%

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Use of novel non‐invasive techniques and biomarkers to guide outpatient management of fluid overload and reduce hospital readmission: systematic review and meta‐analysis

et al. 2021

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Aims Fluid congestion is a leading cause of hospital admission, readmission, and mortality in heart failure (HF). We performed a systematic review and meta-analysis to determine the effectiveness of an advanced fluid management programme (AFMP). The AFMP was defined as an intervention providing tailored diuretic therapy guided by intravascular volume assessment, in hospitalized patients or after discharge. The AFMP group was compared with patients who received standard care treatment. The aim of this systematic review and meta-analysis was to determine the effectiveness of an AFMP in improving patient outcomes. Methods and results A systematic review of randomized controlled trials, case-control studies, and crossover studies using the terms 'heart failure', 'fluid management', and 'readmission' was conducted in PubMed, CINAHL, and Scopus up until November 2020. Studies reporting the association of an AFMP on readmission and/or mortality were included in our metaanalyses. Risk of bias was assessed in non-randomized studies using the Newcastle-Ottawa Scale. From 232 retrieved studies, 12 were included in the data synthesis. The 6040 patients in the included studies had a mean age of 72 ± 4 years and mean left ventricular ejection fraction of 39 ± 8%, there were slightly more men (n = 3022) than women, and the follow-up period was a mean of 4.8 ± 3.1 months. Readmission data were available in 5362 patients; of these, 1629 were readmitted. Mortality data were available in 5787 patients; of these, 584 died. HF patients who had an AFMP in hospital and/or after discharge had lower odds of all-cause readmission (odds ratio-OR 0.64 [95% confidence interval-CI 0.44, 0.92], P = 0.02) with moderate heterogeneity (I 2 = 46.5) and lower odds of all-cause mortality (OR 0.82 [95% CI 0.69, 0.98], P = 0.03) with low heterogeneity (I 2 = 0). The use of an AFMP was equally effective in reducing readmission and mortality regardless of age and follow-up duration. Effective pre-discharge diuresis was associated with significantly lower readmission odds (OR 0.43 [95% CI 0.26, 0.71], P = 0.001) compared with a fluid management plan as part of post-discharge follow-up. Conclusions An effective AFMP is associated with improving readmission and mortality in HF. Our results encourage attainment of optimal volume status at discharge and prescription of optimal diuretic dose. Ongoing support to maintain euvolaemia and effective collaboration between healthcare teams, along with effective patient education and engagement, may help to reduce adverse outcomes in HF patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Interventionsmentioning

confidence: 99%

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Use of novel non‐invasive techniques and biomarkers to guide outpatient management of fluid overload and reduce hospital readmission: systematic review and meta‐analysis

et al. 2021

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“…A recent study tested the effect of fluid management education including fluid monitoring and fluid management in a larger context, with promising results regarding hospitalisations due to HF related to decompensations. 18 how should we think about fluid restriction?…”

Section: Discussionmentioning

confidence: 99%

Fluid restriction in patients with heart failure: how should we think?

Johansson

Wal

Strömberg

et al. 2016

European Journal of Cardiovascular Nursing

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Fluid restriction should not be recommended to all heart failure patients. However, temporary fluid restriction can be considered in decompensated heart failure and/or patients with hyponatremia. Tailored fluid restriction based on body weight (30 ml/kg per day) seems to be most reasonable. To increase adherence to temporary fluid restriction, education, support and planned evaluations can be recommended.

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Patterns of adherence to diuretics, dietary sodium and fluid intake recommendations in adults with heart failure

Riegel

Lee

Hill³

et al. 2019

Heart & Lung

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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.

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A comparative study of fluid management education before hospital discharge

Cited by 5 publications

References 30 publications

Use of novel non‐invasive techniques and biomarkers to guide outpatient management of fluid overload and reduce hospital readmission: systematic review and meta‐analysis

Use of novel non‐invasive techniques and biomarkers to guide outpatient management of fluid overload and reduce hospital readmission: systematic review and meta‐analysis

Fluid restriction in patients with heart failure: how should we think?

Patterns of adherence to diuretics, dietary sodium and fluid intake recommendations in adults with heart failure

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