Introduction:
Poor adherence to the low sodium diet (LSD), common in patients with heart failure (HF), is a major predictor of hospitalization for exacerbation of HF. When family member’s consume the same LSD recommended for patients, patient adherence is increased. The Sodium Watcher Program (SWAP) was developed to improve adherence to LSD using a gradual adaptation strategy and an electronic salt monitoring device that allows detection of sodium content in food. The purpose of this study was to examine whether the SWAP was feasible and if it resulted in reduction in sodium intake for patients with HF and their caregivers.
Method:
In this 2-group randomized controlled trial, 15 patient-caregiver dyads completed 24-hour urine collection for sodium excretion level (24h UNa) at baseline and 3 months follow up. Dyads in the SWAP intervention (n=8) received 12 weeks of self-care education for HF and LSD with gradual adaptation strategies in salt intake via 2 home visits and 4 calls. Paired t-test was used to compare adherence to LSD at two data collection times. Only intervention group evaluated use of the electronic salt monitoring devices and the intervention program at 3 months.
Results:
The intervention group had a significant reduction in 24h UNa (Patients 3894mg vs. 3604mg, p=.02; caregivers 4123mg vs. 3380mg, p<.05). They also reported significant increased level of enjoying eating LSD (M =5.4 on 10-point rating scale vs. M=7.9 p <.01) and 90% noticed a change in their ability to taste salt in their food at the 3-month follow up. They reported that use of the electronic monitoring devices was easy (M=8.3 on 10-point rating scale) and helpful in supporting LSD adherence (M=8.8 on 10-point rating scale). Caregivers in the intervention reported no significant changes in burden levels. The usual care control group had no change in 24h UNa (patients 4369 mg vs. 4434 mg; caregivers 3301 mg vs. 4826mg).
Conclusion:
The findings demonstrated that the SWaP is feasible and efficacious for following LSD by dyads. The intervention was feasible for caregivers and did not increase caregiver burden. This family intervention may have potential for promoting long-term adherence and needs to be tested in a larger clinical trial.
Change in Knowledge of and Adherence to the Low-Sodium Diet in Patients with Heart Failure after Nutrition Education by a Registered Dietitian Nutritionist
