Therapietrouw voor leefregels bij hartfalen*

Objective

To assess long-term compliance with lifestyle recommendations in patients with heart failure.

Design

Descriptive, prospective.

Method

Data from 648 patients hospitalised for heart failure were analysed. Compliance with diet, fluid restriction, daily weighing and exercise was assessed using questionnaires at admission and 1, 6, 12, and 18 months after discharge. Questionnaires pertaining to depressive symptoms, knowledge on heart failure and physical functioning were completed at admission. Logistic regression analyses were performed to examine which variables were independently associated with low long-term compliance.

Results

At admission and during the follow-up after 18 months, long-term compliance with diet and fluid restriction was 77%-91% and 72%-89%, respectively. Compliance with daily weighing (34%-85%) and exercise (48%-64%) was considerably lower. The patients who became symptomatic during strenuous activity were less compliant with fluid restriction (odds ratio (OR) 1.97; 95% CI 1.25-3.08). A lower level of knowledge on heart failure was independently associated with low compliance with fluid restriction (OR 0.78; 95% CI 0.71-0.86) and weighing (OR 0.86; 95% CI 0.79-0.94). Additional information resulted in improved compliance with these two recommendations. Female sex (OR 1.91; 95% CI 1.26-2.90), a history of stroke (OR 3.55; 95% CI 1.54-8.16), and reduced physical functioning (OR 0.99; 95% CI 0.98-0.99) were associated with low long-term compliance with exercise.

Conclusion

Long-term compliance with daily weighing and exercise was lower than long-term compliance with diet and fluid restriction. Although knowledge and education were linked to increased compliance with weighing and fluid restriction, these variables did not affect compliance with exercise. New approaches to increase compliance with exercise are needed.

Conflict of interest: none declared. Financial support: this study was funded by the Dutch Heart Foundation (Nederlandse Hartstichting, 2000Z003).