Patterns of adherence to diuretics, dietary sodium and fluid intake recommendations in adults with heart failure
Patterns of adherence to diuretics, dietary sodium and fluid intake recommendations in adults with heart failure
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DOI：
10.1016/j.hrtlng.2018.12.008
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发表时间：
2019-05-01
期刊：
影响因子：
2.8
通讯作者：
Knafl, George J.
中科院分区：
文献类型：
--
作者：
Riegel, Barbara;Lee, Solim;Knafl, George J.
背景：提倡尽量减少心力衰竭（HF）患者因液体相关住院的三种行为是限制钠和液体的摄入以及持续使用口服利尿剂。人们认为，遵守旨在降低住院风险的行为会随着时间的推移而变化，但令人惊讶的是，很少有研究探讨心力衰竭患者的遵守模式。目的：描述心衰成人 3 种推荐的自我护理行为（即饮食、液体摄入和利尿剂剂量）随时间的变化模式，并确定时间和行为如何影响依从率。方法：我们招募了 24 名因心力衰竭恶化住院并服用袢利尿剂出院的成年人进行描述性纵向试点研究。在超过 3 个月的时间里，使用电子事件监测来测量利尿剂的使用情况，并定期给参与者打电话以评估钠和液体的摄入量。每两周汇总一次数据。结果：低钠饮食的总体依从率为 42.4%，液体限制的总体依从率为 96.4%，利尿方案的总体依从率为 84.7%。出院后早期，药物依从性最高，饮食依从性最低，但随着时间的推移，饮食和利尿使用的依从性显着下降。结论：尽管参与者在心力衰竭急性加重后刚刚出院，但在 3 个月的随访期间，所有三种行为模式均显着下降。 (C) 2018 Elsevier Inc. 保留所有权利。
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. Methods: We enrolled 24 adults hospitalized for a HF exacerbation and discharged on a loop diuretic into a descriptive, longitudinal pilot study. Over 3-months, diuretic use was measured using electronic event monitoring, and participants were telephoned regularly to assess sodium and fluid intake. Data were summarized for each 2-week intervals. Results: The overall adherence rates were 42.4% for low sodium diet, 96.4% for fluid restriction, and 84.7% for the diuretic regimen. Early after hospital discharge, medication adherence was the highest, and dietary adherence was the lowest, but adherence to diet and diuretic use decreased significantly over time. Conclusion: Although participants were just discharged from the hospital after an acute exacerbation of HF, all three behavioral patterns decreased markedly over the 3-month follow-up period. (C) 2018 Elsevier Inc. All rights reserved.