title: Is adherence to weight monitoring or weight-based diuretic self-adjustment associated with fewer heart failure-related emergency department visits or hospitalizations?
abstract: BACKGROUND
  Heart failure (HF) self-care interventions can improve outcomes, but less than optimal adherence may limit their effectiveness. We evaluated if adherence to weight monitoring and diuretic self-adjustment was associated with HF-related emergency department (ED) visits or hospitalizations.
  
  
  RESULTS
  We performed a case-control analysis nested in a HF self-care randomized trial. Participants received HF self-care training, including weight monitoring and diuretic self-adjustment, which they were to record in a diary. We defined case time periods as HF-related ED visits or hospitalizations in the 7 preceding days; control time periods were defined as 7-day periods free of ED visits and hospitalizations. We used logistic regression to compare weight monitoring and diuretic self-adjustment adherence in case and control time periods, adjusted for demographic and clinical covariates. Among 303 participants, we identified 81 HF-related ED visits or hospitalizations (cases) in 54 patients over 1 year of follow-up. Weight monitoring adherence (odds ratio [OR] 0.42, 95% confidence interval [CI] 0.23-0.76) and diuretic self-adjustment adherence (OR 0.44, 95% CI 0.19-0.98) were both associated with lower adjusted odds of HF-related ED visits or hospitalizations.
  
  
  CONCLUSIONS
  Adherence to weight monitoring and diuretic self-adjustment was associated with lower odds of HF-related ED visits or hospitalizations. Adherence to these activities may reduce HF-related morbidity.
authors: Department of Social Medicine, University of North Carolina-Chapel Hill, NC, USA.
authors: Christine D
authors: CD
authors: Jones
authors: George M
authors: GM
authors: Holmes
authors: Darren A
authors: DA
authors: Dewalt
authors: Brian
authors: B
authors: Erman
authors: Kimberly
authors: K
authors: Broucksou
authors: Victoria
authors: V
authors: Hawk
authors: Crystal W
authors: CW
authors: Cene
authors: Jia-Rong
authors: JR
authors: Wu
authors: Michael
authors: M
authors: Pignone
mesh_terms: D001835:Body Weight; D016022:Case-Control Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance; D016032:Randomized Controlled Trials as Topic; D012646:Self Administration; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000627:therapeutic use*; D014481:United States / Q000453:epidemiology; D015430:Weight Gain
chemical_list: D049994:Sodium Potassium Chloride Symporter Inhibitors