Abstract 1545: Theory-based Intervention Increases Low-sodium Diet Adherence in Patients With Heart Failure
Background: Explicit teaching regarding dietary sodium restriction is essential to adherence in patients with chronic heart failure (HF). Additional research is needed to identify effective interventions to improve adherence and impact health-related quality of life (HRQL).
Purpose: The purpose of this study was to demonstrate the effect of an intervention based on the Theory of Planned Behavior on low-sodium diet adherence and HRQL in patients with HF.
Methods: Patients with HF (51% female; age 63±11 years; ejection fraction 41±19%) were recruited into a randomized controlled trial of an educational intervention addressing the constructs (i.e., attitudes, subjective norm, and perceived behavioral control) aimed at reducing dietary sodium intake. The intervention group (n= 20) received individualized teaching and guidance during 4 home visits and 3 telephone calls. The control group (n=24) received usual care. The 24-hour urine sodium excretion (UNA) was used to reflect adherence. The Minnesota Living with Heart Failure Questionnaire was used to measure HRQL. Repeated measures of ANOVA was used to examine group differences in UNA and quality of life at baseline and at 6 weeks.
Results: Mean UNA was 3565±1865 mg. More than 25% of patients had a UNA ≥5000 mg. Patients in the intervention group demonstrated a substantial reduction in UNA at 6 weeks (2750 mg) compared to their baseline (3688 mg) and with the control group (3114 mg baseline; 3868 mg at 6 weeks) in which UNA did not significantly change (p=0.04). The intervention group reported an improvement in HRQL at 6 weeks compared to their baseline and with the control group in which HRQL was unchanged (p=0.01).
Conclusion: Adherence to the low-sodium diet can be substantially improved using a theory based intervention. The improvement in adherence is associated with an improvement in patients’ HRQL.