Weight and symptom diary for self-monitoring in heart failure clinic patients.

BACKGROUND For people with chronic heart failure, self-monitoring has been linked with improved body awareness and better communication with health professionals. Cognitive theory and the concept of somatic awareness help explain self-monitoring behaviors. This study compares the clinical and hospital outcomes of heart failure patients who are using and not using a diary to record weight, vital signs and, symptoms and evaluates the diary format. METHODS All patients enrolling in an outpatient heart failure clinic were given a Heart Health Diary. Seventy patients used the diary and 54 did not. A review of these 124 patients (82 men and 42 women) was completed 6 months after enrollment. RESULTS Diary nonusers were more likely to be younger women with a lower ejection fraction and worse functional status. Those using a diary had 35% and 47% more contacts via telephone and clinic, respectively. Both groups had significant functional and B-type natriuretic peptide improvement. If hospitalized after enrollment in the heart failure clinic, average length of stay for all hospital admissions for diary users decreased by 58% (P < .002) and average cost per case decreased by 56% (P < .011). Length of stay and cost per case did not significantly change for those not using diaries. CONCLUSION Diary users showed evidence of improved clinical and hospital outcomes. Further investigation is needed to clarify the characteristics of a diary user and the effect of diary use on self-management and outcomes.