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Cited by 27Heart Failure Treatment and ManagementCardiac Health and Mental HealthMobile Health and mHealth Applications

Symptom Diary Use and Improved Survival for Patients With Heart Failure

Open access
Park, Linda G., Dracup, Kathleen, Whooley, Mary A., McCulloch, Charles, Jin, Chengshi, Moser, Debra K., Clark, Robyn A., Pelter, Michele M. +2 more·2017·Circulation: Heart Failure
DOI 10.1161/circheartfailure.117.003874PMC PMC5705062
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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 this 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 men, and 67% completed diaries (n=393). We formed 5 groups (no use, low, medium, high, and very high) based on the first 3 months of diary use and then analyzed time to event (cardiac mortality, all-cause mortality, and 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 (odds ratio, 0.66; 95% confidence interval, 0.46–0.95; P =0.03). Depression and sex were not significant predictors of diary use in the adjusted model. Conclusions: 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. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique Identifier: NCT00415545.

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  • 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.

    “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]”

    From Technology enabled clinical care (TECC): Protocol for a prospective longitudinal cohort study of smartphone-augmented mental health treatment (2021) · cites this paper as [43]

    The Abstract (Methods and Results; page not supplied) reports that greater diary use among patients with established heart failure was associated with lower all-cause mortality. The paper does not establish a benefit for people merely at risk of heart failure, or for chronic bronchitis or other pulmonary diseases. (LLM, conf=0.87)

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Authors
Park, L. G., Dracup, K., Whooley, M. A., McCulloch, C., Jin, C., Moser, D. K., Clark, R. A., Pelter, M. M., Biddle, M., & Howie Esquivel, J.
Affiliations
  • San Francisco VA Medical Center (US)
  • From the Department of Community Health Systems (L.G.P.), Department of Physiological Nursing (K.D., M.M.P.), Department of Medicine (M.A.W.), Department of Epidemiology & Biostatistics (M.A.W., C.M., C.J.), University of California, San Francisco, CA; Department of Acute & Specialty Care, University of Virginia, Charlottesville (J.H.E.); San Francisco Veterans Affairs Medical Center, San Francisco, CA (L.G.P., M.A.W.); College of Nursing, University of Kentucky, Lexington (D.K.M., M.B.);...
ORCID
Venue
Circulation: Heart Failure
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2017-11
Volume
10
Issue
11
ISSN
  • 1941-3289 (ISSN-L)
  • 1941-3297
DOI
10.1161/circheartfailure.117.003874
PMC
PMC5705062
OpenAlex
W2769001661
Cited by
27
References
45
Citations by year
2026: 1 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 5 · 2021: 5 · 2020: 7 · 2019: 1 · 2018: 1
FWCI
1.89
Type
journal article
Language
en
Update notices
correction (2017-12-04)
Open access
Locations
  • Circulation Heart Failure (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institutes of Health (UL1TR000004, TR000004, KL2TR001870)
  • University of California, San Francisco (TR000004, UL1-TR000004)
  • National Heart, Lung, and Blood Institute (5R01HL83176‐5, R01HL083176)
  • National Institute of Nursing Research (5R01HL83176‐5)
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (K24AR051895)
  • National Center for Advancing Translational Sciences (TR000004)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
heart failure, symptom diary, patient self-care, mortality, all-cause mortality, heart failure readmission, rural patients, weight gain monitoring, dyspnea, sedentary lifestyle, patient engagement, patient education
MeSH terms
Aged, Cause of Death, Dyspnea, Female, Health Status, Heart Failure, Humans, Health Knowledge, Attitudes, Practice, Lung, Male, Middle Aged, Patient Compliance, Patient Education as Topic, Patient Participation, Patient Readmission, Respiration, Risk Factors, Self Care, Time Factors, United States, Weight Gain, Odds Ratio, Treatment Outcome, Rural Health Services, Sedentary Behavior

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