A Trial of Family Partnership and Education Interventions in Heart Failure

• Published in: Journal of cardiac failure Vol. 19; no. 12; pp. 829 - 841
• Main Authors: Dunbar, Sandra B., RN, DSN, FAHA, FAAN, Clark, Patricia C., RN, PhD, FAHA, FAAN, Reilly, Carolyn M., RN, PhD, CHFN, FAHA, Gary, Rebecca A., RN, PhD, FAHA, FAAN, Smith, Andrew, MD, McCarty, Frances, PhD, Higgins, Melinda, PhD, Grossniklaus, Daurice, RN, PhD, Kaslow, Nadine, PhD, Frediani, Jennifer, RD, Dashiff, Carolyn, RN, PhD, Ryan, Richard, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2013
• Subjects: adherence; Adult; Aged; autonomy support; Cardiovascular; dietary sodium; Female; Heart Failure - epidemiology; Heart Failure - psychology; Heart Failure - therapy; Humans; Male; medication adherence; Medication Adherence - psychology; Middle Aged; Patient Education as Topic - methods; Professional-Family Relations; Self management; Self Report - standards; Sodium Chloride, Dietary - administration & dosage; Sodium Chloride, Dietary - adverse effects; Self management; medication adherence; autonomy support; adherence; dietary sodium
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2013.10.007

Abstract Background Lowering dietary sodium and adhering to medication regimens are difficult for persons with heart failure (HF). Because these behaviors often occur within the family context, this study evaluated the effects of family education and partnership interventions on dietary sodium (Na) intake and medication adherence (MA). Methods and Results HF patient and family member (FM) dyads (n = 117) were randomized to: usual care (UC), patient-FM education (PFE), or family partnership intervention (FPI). Dietary Na (3-day food record), urinary Na (24-hour urine), and MA (Medication Events Monitoring System) were measured at baseline (BL) before randomization, and at 4 and 8 months. FPI and PFE reduced urinary Na at 4 months, and FPI differed from UC at 8 months ( P  = .016). Dietary Na decreased from BL to 4 months, with both PFE ( P  = .04) and FPI ( P  = .018) lower than UC. The proportion of subjects adherent to Na intake (≤2,500 mg/d) was higher at 8 months in PFE and FPI than in UC (χ2(2)  = 7.076; P  = .029). MA did not differ among groups across time. Both FPI and PFE groups increased HF knowledge immediately after intervention. Conclusions Dietary Na intake, but not MA, was improved by PFE and FPI compared with UC. The UC group was less likely to be adherent with dietary Na. Greater efforts to study and incorporate family-focused education and support interventions into HF care are warranted.