Self-reported recall and daily diary-recorded measures of weight monitoring adherence: Associations with heart failure-related hospitalization

Christine D. Jones, George M. Holmes, Darren A. DeWalt, Brian Erman, Jia Rong Wu, Crystal W. Cene, David W. Baker, Dean Schillinger, Bernice Ruo, Kirsten Bibbins-Domingo, Aurelia Macabasco-O'Connell, Victoria Hawk, Kimberly Broucksou, Michael Pignone

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31 Scopus citations


Background: Weight monitoring is an important element of HF self-care, yet the most clinically meaningful way to evaluate weight monitoring adherence is uncertain. We conducted this study to evaluate the association of (1) self-reported recall and (2) daily diary-recorded weight monitoring adherence with heart failure-related (HF-related) hospitalization.Methods: We conducted a prospective cohort study among 216 patients within a randomized trial of HF self-care training. All patients had an initial self-care training session followed by 15 calls (median) to reinforce educational material; patients were also given digital scales, instructed to weigh daily, record weights in a diary, and mail diaries back monthly. Weight monitoring adherence was assessed with a self-reported recall question administered at 12 months and dichotomized into at least daily versus less frequent weighing. Diary-recorded weight monitoring was evaluated over 12 months and dichotomized into ≥80% and <80% adherence. HF-related hospitalizations were ascertained through patient report and confirmed through record review.Results: Over 12 months in 216 patients, we identified 50 HF-related hospitalizations. Patients self-reporting daily or more frequent weight monitoring had an incidence rate ratio of 1.34 (95% CI 0.24-7.32) for HF-related hospitalizations compared to those reporting less frequent weight monitoring. Patients who completed ≥80% of weight diaries had an IRR of 0.37 (95% CI 0.18-0.75) for HF-related hospitalizations compared to patients who completed <80% of weight diaries.Conclusions: Self-reported recall of weight monitoring adherence was not associated with fewer HF hospitalizations. In contrast, diary-recorded adherence ≥80% of days was associated with fewer HF-related hospitalizations. Incorporating diary-based measures of weight monitoring adherence into HF self-care training programs may help to identify patients at risk for HF-related hospitalizations.

Original languageEnglish
Article number12
JournalBMC Cardiovascular Disorders
StatePublished - Jan 31 2014

Bibliographical note

Funding Information:
The authors would like to thank all of the study patients for their valuable contributions. This work was supported by the National Heart, Lung, and Blood Institute at the National Institutes of Health [grant number R01 HL081257] and the National Institutes of Health American Recovery and Reinvestment Act [grant number A10-0586-001]. Dr. Christine Jones is supported by a NIH/HRSA training grant and is a NRSA Primary Care Research Fellow (T32HP14001-25). The authors would also like to thank the University of North Carolina Health Sciences Library and University Libraries for providing funding to support open access publishing costs.


  • Heart failure
  • Monitoring
  • Patient compliance
  • Physiologic

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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