title: Changes in Thirst Intensity During Optimization of Heart Failure Medical Therapy by Nurses at the Outpatient Clinic.
abstract: Thirst can be aggravated in patients with heart failure (HF), and optimization of HF medication can have positive impact on thirst.
  
  
  
  The aims of this study were to describe changes in thirst intensity and to determine factors associated with high thirst intensity during optimization of HF medication.
  
  
  
  Patients with HF (N = 66) who were referred to an HF clinic for up-titration of HF medication were included. Data were collected during the first visit to the clinic and at the end of the treatment program. Data were dichotomized by the median visual analog scale score for thirst, dividing patients into 2 groups: low thirst intensity (0-20 mm) and high thirst intensity (>20 mm on a visual analog scale of 0-100 mm). In total, 67% of the patients reported a higher thirst intensity after the HF up-titration program. There was no difference in thirst intensity between the patients who reached target doses and those who did not. Plasma urea level (odds ratio, 1.33; 95% confidence interval, 1.07-1.65) and fluid restriction (odds ratio, 6.25; 95% confidence interval, 1.90-20.5) were independently associated with high thirst intensity in patients with HF.
  
  
  
  Thirst intensity increased in two-thirds of the patients during a time period of optimization of HF medication. Fluid restriction and plasma urea levels were associated with high thirst intensity.
authors.affiliation: Nana Waldréus, RN PhD Student, Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, and Research Coordinator, Department of Research, Södertälje Sjukhus, Södertälje, Sweden. Robert G. Hahn, PhD, MD Adjunct Professor, Department of Medicine Health Sciences, Faculty of Health Sciences, Linköping University, and Director of Department of Research, Södertälje Sjukhus, Södertälje, Sweden. Patrik Lyngå, PhD, RN Heart Failure Nurse, Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden. Martje H. L. van der Wal, PhD, RN Heart Failure Nurse, Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands. Ewa Hägglund, RN Heart Failure Nurse, Karolinska Institutet, Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. Tiny Jaarsma, PhD, RN Professor, Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Sweden.
authors.forename: Nana
authors.initials: N
authors.lastname: Waldréus
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hahn
authors.forename: Patrik
authors.initials: P
authors.lastname: Lyngå
authors.forename: Martje H L
authors.initials: MH
authors.lastname: van der Wal
authors.forename: Ewa
authors.initials: E
authors.lastname: Hägglund
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
mesh_terms: D000554:Ambulatory Care Facilities; D005440:Fluid Therapy; D006333:Heart Failure; D006801:Humans; D013894:Thirst