Self-reported recall and daily diary-recorded measures of weight monitoring adherence: associations with heart failure-related hospitalization
1 Division of General Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
2 The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
3 Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
4 School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
5 Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
6 Division of General Internal Medicine and Center for Vulnerable Populations, Department of Medicine at San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA
7 Olive View-UCLA Medical Center, UCLA School of Nursing, University of California, Los Angeles, CA, USA
8 NRSA Primary Care Fellowship, Division of General Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill, 5034 Old Clinic Building, CB# 7110, Chapel Hill, NC 27599, USA
BMC Cardiovascular Disorders 2014, 14:12 doi:10.1186/1471-2261-14-12Published: 31 January 2014
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.
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.
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.
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.