Symptom Diary Use and Improved Survival for Patients With Heart Failure

Abstract

Background Attention to symptoms of weight gain and dyspnea are central tenets of patient education in heart failure (HF). However, it is not known whether diary use improves patient outcomes. The aims of the study were to compare mortality among rural patients with HF who completed versus did not complete a daily diary of weight and symptom self-assessment and to identify predictors of diary use. Methods and Results This is a secondary analysis of a 3-arm randomized controlled trial on HF education of self-care with 2 intervention groups versus control who were given diaries for 24 months to track daily weight, HF symptoms, and response to symptom changes. Mean age was 66±13, 58% were male, and 67% completed diaries (N=393). We formed 5 groups (No Use, Low, Medium, High, Very High) based on the first 3 months of diary use and then analyzed time to event (cardiac mortality, all-cause mortality, HF-related readmission) starting at 3 months. Compared with patients with No diary use, High and Very High diary users were less likely to experience all-cause mortality (P=0.02 and P=0.01, respectively). Self-reported sedentary lifestyle was associated with less diary use in an adjusted model (OR, 0.66; 95% CI, 0.46–0.95; P=0.03). Depression and gender were not significant predictors of diary use in the adjusted model. Conclusion In this study of 393 rural patients with HF, we found that greater diary use was associated with longer survival. These findings suggest that greater engagement in self-care behaviors is associated with better HF outcomes.

Technology Enabled Clinical Care (TECC): Protocol for a Prospective Longitudinal Cohort Study of Smartphone-Augmented Mental Health Treatment

“…App-related DBT studies have shown potential in allowing users to learn and practice a wide range of skills; however, major barriers include app navigation challenges and difficulties understanding interventions without prior DBT exposure or clinical support [ 41 , 42 ]. Nonetheless, increasing symptom awareness and tracking, via diary cards, have been shown to be helpful for various conditions, including those in jeopardy of heart failure, chronic bronchitis, and pulmonary diseases [ 43 , 44 ].…”

Primera declaración Mexicana en materia de Insuficiencia Cardiaca

“…Education for patients and family members. 16,[55][56][57] Patient, relatives and caregivers empowerment is indispensable to achieve a good therapeutic adherence and to optimize the results of treatment. All educational measures aimed at improving disease awareness, drug management, recognition of alarming data, should be considered within an HF educational program.…”

Diary for self‐observation: A self‐management tool for recipients of lung transplantation—A pilot study

“…Diaries to support the patients have been used in different patients' groups (Jimoh, Bunn, & Hooper, 2015; Park et al., 2017; Ullman et al., 2015) and seem to have increase self‐reliance and self‐management in some patient populations (Van Woensel, Roy, Abidi, & Abidi, 2015). Furthermore, diaries have been used in the pre‐transplant period of candidates for lung transplantation to monitor early detection of clinical problems (Mullan, Snyder, Lindgren, Finkelstein, & Hertz, 2003).…”