Abstract 16922: Feasibility of Family Sodium Watcher Program to Improve Adherence to Low Sodium Diet in Patients with Heart Failure and Caregivers

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Misook L Chung ◽  
Debra K Moser ◽  
Terry A Lennie

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.

2008 ◽  
Vol 114 (3) ◽  
pp. 221-230 ◽  
Author(s):  
Salvatore Paterna ◽  
Parrinello Gaspare ◽  
Sergio Fasullo ◽  
Filippo M. Sarullo ◽  
Pietro Di Pasquale

The aim of the present study was to evaluate the effects of a normal-sodium (120 mmol sodium) diet compared with a low-sodium diet (80 mmol sodium) on readmissions for CHF (congestive heart failure) during 180 days of follow-up in compensated patients with CHF. A total of 232 compensated CHF patients (88 female and 144 male; New York Heart Association class II–IV; 55–83 years of age, ejection fraction <35% and serum creatinine <2 mg/dl) were randomized into two groups: group 1 contained 118 patients (45 females and 73 males) receiving a normal-sodium diet plus oral furosemide [250–500 mg, b.i.d. (twice a day)]; and group 2 contained 114 patients (43 females and 71 males) receiving a low-sodium diet plus oral furosemide (250–500 mg, b.i.d.). The treatment was given at 30 days after discharge and for 180 days, in association with a fluid intake of 1000 ml per day. Signs of CHF, body weight, blood pressure, heart rate, laboratory parameters, ECG, echocardiogram, levels of BNP (brain natriuretic peptide) and aldosterone levels, and PRA (plasma renin activity) were examined at baseline (30 days after discharge) and after 180 days. The normal-sodium group had a significant reduction (P<0.05) in readmissions. BNP values were lower in the normal-sodium group compared with the low sodium group (685±255 compared with 425±125 pg/ml respectively; P<0.0001). Significant (P<0.0001) increases in aldosterone and PRA were observed in the low-sodium group during follow-up, whereas the normal-sodium group had a small significant reduction (P=0.039) in aldosterone levels and no significant difference in PRA. After 180 days of follow-up, aldosterone levels and PRA were significantly (P<0.0001) higher in the low-sodium group. The normal-sodium group had a lower incidence of rehospitalization during follow-up and a significant decrease in plasma BNP and aldosterone levels, and PRA. The results of the present study show that a normal-sodium diet improves outcome, and sodium depletion has detrimental renal and neurohormonal effects with worse clinical outcome in compensated CHF patients. Further studies are required to determine if this is due to a high dose of diuretic or the low-sodium diet.


2016 ◽  
Vol 31 (6) ◽  
pp. 529-534 ◽  
Author(s):  
Eun Kyeung Song ◽  
Debra K. Moser ◽  
Seok-Min Kang ◽  
Terry A. Lennie

Diabesity ◽  
2019 ◽  
Vol 5 (3) ◽  
Author(s):  
Candice A Tan ◽  
Sarah J Holland ◽  
Marisa E Mozer ◽  
Kali E Sarcinella ◽  
Christy C Tangney ◽  
...  

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