Patterns of adherence to diuretics, dietary sodium and fluid intake recommendations in adults with heart failure.
Barbara Riegel, Solim Lee, Julia Hill and 4 others
PMID 30638609WHAT IT FOUND
Heart failure patients followed fluid restrictions and took diuretics well but ignored sodium limits.
Adherence to diet and medication dropped rapidly after discharge, while fluid adherence remained high. Patients prioritize some self-care behaviors over others.
Key findings
01Overall adherence rates were 42.4% for low sodium diet, 96.4% for fluid restriction, and 84.7% for the diuretic regimen.
02Adherence trends decreased over time, with significant declines in diet (16.1% point) and medication adherence (22.8% point).
03A common pattern was poor dietary adherence yet excellent fluid adherence and good diuretics adherence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample size was small (24 participants), limiting generalizability. Dietary sodium intake was assessed via self-report using a checklist, which has not been validated against objective measures like urinary sodium. Fluid intake was estimated by participants using their own containers, relying on self-judgment. The study did not measure thirst or other factors that might influence fluid adherence. It was a convenience sample from a single institution.
The easy way to misread this
Do not assume that high adherence to one behavior, such as fluid restriction, indicates good adherence to others, such as dietary sodium restriction or medication taking. The study shows these behaviors are independent, with sodium adherence being particularly poor and declining rapidly after discharge.