Patients differ in their ability to self-monitor adherence to a low-sodium diet versus medication.
OBJECTIVE
Poor adherence to a low-sodium diet (LSD) and prescribed medications increases rehospitalization risk in patients with heart failure (HF). Clinicians have difficulty assessing adherence objectively, so they depend on patients' self-report. The degree to which self-reported adherence reflects actual adherence is unclear. We examined patients' ability to self-monitor adherence to an LSD and medications by comparing self-reported adherence with objective evidence of adherence.


METHODS
A total of 133 patients with HF (male 71%; ejection fraction 35% +/- 14%) completed the Medical Outcomes Study Specific Adherence Scale. Adherence to the LSD and medication were assessed objectively using 24-hour urinary sodium excretion and dose counting with an electronic monitoring device, respectively. On the basis of self-report, patients were divided into adherent and non-adherent groups and evaluated for differences according to objective adherence.


RESULTS
There were no differences in urinary sodium levels between the self-reported LSD adherent and non-adherent groups (4560 mg vs. 4333 mg; P = .59). Self-reported adherent and non-adherent medication groups took 92.4% and 80.4% of prescribed doses, respectively (P < .001).


CONCLUSIONS
Patients were able to accurately estimate adherence to medication, but they failed to estimate LSD adherence. This finding suggests that we need to improve our means of evaluating adherence to the LSD and of educating patients more thoroughly about following the LSD. We speculated that the inability to estimate LSD adherence may be the result of gaps in patients' knowledge that preclude accurate self-assessment.
Chung
Misook L
ML
College of Nursing, University of Kentucky, Lexington, KY 40536-0232, USA. misook.chung@uky.edu
Lennie
Terry A
TA
de Jong
Marla
M
Wu
Jia-Rong
JR
Riegel
Barbara
B
Moser
Debra K
DK
D004039:Diet, Sodium-Restricted; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012648:Self Care; D018434:Sickness Impact Profile; D012982:Sodium, Dietary; D013318:Stroke Volume
D012982:Sodium, Dietary