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

Riegel, Bárbara; Lee, Solim; Hill, Julia; Daus, Marguerite; Baah, Foster Osei; Wald, Joyce; Knafl, George J.

doi:10.1016/j.hrtlng.2018.12.008

Cited by 39 publications

(49 citation statements)

References 51 publications

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“…Multiple authors have described problems with compliance with a low-sodium diet. In a study by Riegel et al, patients scored particularly low in terms of a low-salt diet, and the authors reported that the problem often resulted from a misinterpretation or misunderstanding of the prescribed restrictions [15]. Many patients following a diet do not pay attention to the sodium content in each product that they eat.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, the level of compliance with the recommended fluid restriction was also very low. According to Riegel et al, lack of fluid restriction in patients' diets may be explained by difficulties in the precise determination of one's fluid intake, as well as not testing for thirst levels, which may be significant to this area of compliance [15].…”

Section: Plos Onementioning

confidence: 99%

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Patient-Reported Compliance in older age patients with chronic heart failure

et al. 2020

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The purpose of the study was to evaluate compliance with medical treatment in elderly patients with heart failure (HF), and to identify factors that associated with patients' compliance levels. Methods and results 475 patients (including 222 women), mean age 69.7±7.7, with HF, hospitalized at University Hospital between January and December 2018 were included in the study. The patients were selected by a physician specializing in cardiology. A cardiac nurse assessed the non-pharmacological level of compliance using the Revised Heart Failure Compliance Questionnaire (RHFCQ). The socio-clinical data were obtained from medical records. The majority of the study group were patients in NYHA II (62.4%) and NYHA III (28.3%), the mean duration of the disease was 6.2±4.9 years, and the mean ejection fraction of the left ventricle (EF) was 48.6±12.6. The average level of compliance in the study group measured on a scale from 0 to 4 points was: median = 2.7, IQR [2.32; 3.25]. Only 6.9% of the respondents adhere to recommendations totally (all dimensions of RHFCQ). In univariate analysis, predictors negatively affecting compliance were: female gender (rho =-0.325), age below 65 years (rho =-0.014)), loneliness (rho =-0.559), number of hospitalizations (rho =-0.242), higher stage of NYHA (rho =-1.612), co-morbidities (rho =-0.729), re-hospitalizations (rho =-0.729), beta-blockers treatment (rho =-1.612) and diuretics treatment (rho =-0.276). Factors positively affecting compliance were: EF�45% (rho = 0.020) and treatment with ACEI/ARB (rho = 0.34), whereas compliance was negatively affected by-EF<45% (β = 0.009). Independent predictors influencing the level of compliance were: loneliness (β =-1.816), number of hospitalizations (β =-0.117), NYHA III and IV and number of co-morbidities (β =-0.676).

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Section: Discussionmentioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Patient-Reported Compliance in older age patients with chronic heart failure

et al. 2020

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“…This process is not a linear trajectory but a progression through different stages shaped by HF patients' attitudes, strategies and support, demanding constant effort to maintain health. Burdens related to treatment and self‐care in HF have been characterized in prior research as overwhelming, difficult work; and adherence to HF self‐care and treatment regimens has been reported to be low (Gallacher et al, ; Mlynarska et al, ; Riegel et al, ). Despite patients' knowledge of self‐care tasks, the burden of the illness and treatment generates problems in maintaining self‐efficacy, which is a personal attribute that changes over time by learning from attempts to manage the HF condition (Nordfonn, Morken, Bru, & Husebø, ; Riegel et al, ; Spaling, Currie, Strachan, Harkness, & Clark, ).…”

Section: Introductionmentioning

confidence: 99%

A qualitative study of living with the burden from heart failure treatment: Exploring the patient capacity for self‐care

2020

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Aim To explore how patients with heart failure perceive their capacity to manage treatment and self‐care. Design A qualitative descriptive study. Methods Patients (N = 17) were recruited from a nurse‐led heart failure outpatient clinic from May–August 2017. Data were collected through individual semi‐structured interviews and analysed using systematic text condensation. Results Three main themes were identified as follows: “Personal characteristics,” “Coping strategies” and “Emotional and informative support.” The first main theme contained the subthemes “inherent strength” and “maintenance of a positive attitude.” The second main theme included the subthemes “selective denial,” “ability to adapt by setting new goals” and “careful selection of information.” The third main theme contained the subthemes “support from health professionals enhancing patient capacity,” “support from next of kin in patients' self‐care” and “practical support and hope from peers.”

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“…Undoubtedly, this is not an easy task. Adherence to a low-salt diet of hemodialysis patients is poor [18,19] as well as in patients with other chronic diseases [20][21][22][23][24][25][26][27][28], even though a high percentage of patients on hemodialysis recognize that salty food is not good for them [18,37,38]. Sevick et al showed that nutritional counseling and a technology-supported behavioral intervention resulted in reduced dietary sodium intake at 8 weeks, however, it was not sustained at 16 weeks [39].…”

Section: Discussionmentioning

confidence: 99%

“…Nephrologists routinely recommend restriction of salt, but unfortunately it is difficult to obtain in daily clinical practice. Adherence to a low-salt diet of hemodialysis patients is poor [18] as well as in patients with other chronic diseases such as heart failure, hypertension, and cirrhosis [19][20][21][22][23][24][25][26][27]. Many factors contribute to such poor adherence such as lack of knowledge, interference with socialization, low education level, low socioeconomic status, and lack of food selections [10].…”

Section: Introductionmentioning

confidence: 99%

Dietary Daily Sodium Intake Lower than 1500 mg Is Associated with Inadequately Low Intake of Calorie, Protein, Iron, Zinc and Vitamin B1 in Patients on Chronic Hemodialysis

et al. 2020

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Background: To measure daily sodium intake in patients on chronic hemodialysis and to compare the intake of nutrients, minerals, trace elements, and vitamins in patients who had a daily sodium intake below or above the value of 1500 mg recommended by the American Heart Association. Methods: Dietary intake was recorded for 3 days by means of 3-day diet diaries in prevalent patients on chronic hemodialysis. Each patient was instructed by a dietitian on how to fill the diary, which was subsequently signed by a next of kin. Results: We studied 127 patients. Mean sodium intake (mg) was 1295.9 ± 812.3. Eighty-seven (68.5%) patients had a daily sodium intake <1500 mg (group 1) and 40 (31.5%) ≥ 1500 mg (group 2). Correlation between daily sodium intake and daily calorie intake was significant (r = 0.474 [0.327 to 0.599]; p < 0.0001). Daily calorie intake (kcal/kg/day) was lower in group 1 (21.1 ± 6.6; p = 0.0001) than in group 2 (27.1 ± 10.4). Correlation between daily sodium intake and daily protein intake was significant (r = 0.530 [0.392 to 0.644]; p < 0.0001). The daily protein intake (grams/kg/day) was lower in group 1 (0.823 ± 0.275; p = 0.0003) than in group 2 (1.061 ± 0.419). Daily intake of magnesium, copper, iron, zinc, and selenium was significantly lower in group 1 than in group 2. Daily intake of vitamin A, B2, B3, and C did not differ significantly between group 1 and group 2. Daily intake of vitamin B1 was significantly lower in group 1 than in group 2. Significantly lower was, in group 1 than in group 2, the percentage of patients within the target value with regard to intake of calories (11.5% vs. 37.5%; p = 0.001) and proteins (9.2% vs. 27.5%; p = 0.015) as well as of iron (23% vs. 45%; p = 0.020), zinc (13.8% vs. 53.8%; p = 0.008) and vitamin B1 (8.1% vs. 50%; p < 0.001). Conclusion: A low daily intake of sodium is associated with an inadequately low intake of calorie, proteins, minerals, trace elements, and vitamin B1. Nutritional counselling aimed to reduce the intake of sodium in patients on chronic hemodialysis should not disregard an adequate intake of macro- and micronutrients, otherwise the risk of malnutrition is high.

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

Cited by 39 publications

References 51 publications

Patient-Reported Compliance in older age patients with chronic heart failure

Patient-Reported Compliance in older age patients with chronic heart failure

A qualitative study of living with the burden from heart failure treatment: Exploring the patient capacity for self‐care

Dietary Daily Sodium Intake Lower than 1500 mg Is Associated with Inadequately Low Intake of Calorie, Protein, Iron, Zinc and Vitamin B1 in Patients on Chronic Hemodialysis

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