Self-reported recall and daily diary-recorded measures of weight monitoring adherence: associations with heart failure-related hospitalization.
BACKGROUND
Weight monitoring is an important element of HF self-care, yet the most clinically meaningful way to evaluate weight monitoring adherence is uncertain. We conducted this study to evaluate the association of (1) self-reported recall and (2) daily diary-recorded weight monitoring adherence with heart failure-related (HF-related) hospitalization.


METHODS
We conducted a prospective cohort study among 216 patients within a randomized trial of HF self-care training. All patients had an initial self-care training session followed by 15 calls (median) to reinforce educational material; patients were also given digital scales, instructed to weigh daily, record weights in a diary, and mail diaries back monthly. Weight monitoring adherence was assessed with a self-reported recall question administered at 12 months and dichotomized into at least daily versus less frequent weighing. Diary-recorded weight monitoring was evaluated over 12 months and dichotomized into ≥80% and <80% adherence. HF-related hospitalizations were ascertained through patient report and confirmed through record review.


RESULTS
Over 12 months in 216 patients, we identified 50 HF-related hospitalizations. Patients self-reporting daily or more frequent weight monitoring had an incidence rate ratio of 1.34 (95% CI 0.24-7.32) for HF-related hospitalizations compared to those reporting less frequent weight monitoring. Patients who completed ≥80% of weight diaries had an IRR of 0.37 (95% CI 0.18-0.75) for HF-related hospitalizations compared to patients who completed <80% of weight diaries.


CONCLUSIONS
Self-reported recall of weight monitoring adherence was not associated with fewer HF hospitalizations. In contrast, diary-recorded adherence ≥80% of days was associated with fewer HF-related hospitalizations. Incorporating diary-based measures of weight monitoring adherence into HF self-care training programs may help to identify patients at risk for HF-related hospitalizations.
Division of General Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. delong.christine@gmail.com.
Christine D
CD
Jones
George M
GM
Holmes
Darren A
DA
DeWalt
Brian
B
Erman
Jia-Rong
JR
Wu
Crystal W
CW
Cene
David W
DW
Baker
Dean
D
Schillinger
Bernice
B
Ruo
Kirsten
K
Bibbins-Domingo
Aurelia
A
Macabasco-O'Connell
Victoria
V
Hawk
Kimberly
K
Broucksou
Michael
M
Pignone
D001835:Body Weight; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010349:Patient Compliance; D010353:Patient Education as Topic; D011446:Prospective Studies; D012307:Risk Factors; D012648:Self Care; D057566:Self Report; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States