Evaluation of simplified fluid intake and output recording schemes for the self-management in patients with heart failure: a randomized controlled trial

Abstract

Background Fluid management plays a pivotal role for heart failure (HF) patients. Medical fluid intake and output recording scheme by health care professional is complicated, which is not easily conducive to carry out by HF patients for self-management at home. This study aimed to optimize the professional fluid records for the self-management of HF patients and evaluate the effectiveness of this simplified recording scheme of fluid intake and output. Methods A randomized, non-blinded, non-inferiority trial with allocation concealment was conducted. Participants meeting the diagnostic criteria for HF were randomly assigned to professional recording group (PRG) and simplified recording group (SRG) according to the random allocation sequence generated by online tool. Days from admission to clinical stability (primary outcome), clinical congestion score (CCS), Minnesota Living with Heart Failure Questionnaire (MLHFQ) and frequency of electrolyte disturbances (secondary outcomes) were collected. The outcomes judges were blinded to group assignment.Results A total of 140 HF patients were enrolled and randomly divided into PRG (n=70) and SRG (n=70). Ultimately, 129 HF patients (PRG, n=65, and SRG, n=64) completed these experiments. Compared to PRG patients, SRG patients also improved their HF symptoms (including shortness of breath and fluid retention), and did not show the prolonged hospitalization time after similar intravenous diuretic treatment. Additionally, the parameters of clinical stability, CCS, MLHFQ, electrolyte disturbances and body weight in SRG patients were not inferior to that of PRG patients ( P >0.05). Conclusions This simplified fluid intake and output recording scheme was safe, efficient and non-inferior to the professional mode, which might effectively enhance their feasibility of self-management, and improve their quality of life in HF patients.