Abstract 9185: Is Suboptimal Adherence to Weight Monitoring and/or Weight-Based Diuretic Self-Adjustment Associated with Heart Failure-Related Emergency Department Visits or Hospitalizations?
Notice bibliographique
Résumé
Background Heart failure (HF) self-care interventions that include daily weights and diuretic self-adjustment to manage volume status can improve outcomes, but suboptimal adherence may limit their effectiveness. We sought to evaluate the association of 1) adherence to weight monitoring, and 2) adherence to a weight-based diuretic self-adjustment plan (WBDSA) with HF-related Emergency Department (ED) visits or hospitalizations. Methods We performed a case-control analysis nested in a HF self-care clinical trial. Participants received HF education over one year that covered topics including daily weight monitoring and personalized WBDSA plans. All participants were to record daily weights and loop diuretic doses in a specialized diary. Cases were 7-day periods preceding HF-related ED visits or hospitalizations determined by masked outcome adjudication. Controls were 7-day periods free of ED visits or hospitalizations and were matched to cases 10:1 for age, gender, NYHA class, and study site. Weight monitoring adherence required recording a weight; WBDSA adherence required recording a correct diuretic dose based on the WBDSA plan. Weight monitoring and WBDSA adherence were determined over 7 days and dichotomized into <6 versus >= 6/7 days of adherence. We used logistic regression to evaluate the odds of weight monitoring and WBDSA adherence in cases compared to controls and adjusted for age, gender, NYHA class, study site, literacy, socioeconomic ladder, systolic HF, cardiovascular disease, and chronic kidney disease. Results Among 303 participants, we identified 81 eligible cases [12 ED visits (15%) and 69 hospitalizations (85%)] in 54 patients. Weight monitoring adherence (OR 0.43, 95% CI 0.23, 0.81) and WBDSA adherence (OR 0.36, 95% CI 0.16, 0.82) were both associated with lower adjusted odds of a HF-related ED visit or hospitalization. Results were similar in unadjusted models for both weight monitoring adherence (OR 0.54, 95% CI 0.31, 0.95) and WBDSA adherence (0.36, 95% CI 0.16, 0.81). Conclusions Adherence to daily weight monitoring and WBDSA was associated with lower odds of ED visits or hospitalizations related to HF. Enhancing adoption and adherence for these self-care behaviors may be an important step in reducing HF-related morbidity.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».