Effectiveness Of Weight Management Intervention On Prognosis In Patients With Chronic Congestive Heart Failure

Objective: The objective of the study was to evaluate the effectiveness of weightmanagement (WM) intervention on prognosis among patients with chronic congestiveheart failure (CHF).Methods: The study was consisted of two parts. PartⅠ: In the retrospective survey,data including patients’ demographic data, scores of Weight Management Questionnaire(WMQ), adherence to weight monitoring and rates of CHF-related hospitalization over thelast6months, was collected among CHF patients by convenience sampling. Part Ⅱ: Weperformed a6-month randomized controlled trial. Patients who met our inclusion criteriawere randomized into control group and intervention group. Control group received usualcare, while intervention group received usual care and WM intervention with scheduledtelephone visits, focusing on education of daily weight monitoring and actions to deal withsudden weight increase. Scores of WMQ, adherence to weight monitoring, NYHAclassifications, CHF-related re-hospitalization and scores of Minnesota Living with HeartFailure Questionnaire (MLHFQ) were compared at enrollment and at6month.Results: PartⅠ: The survey indicated a low level of WM ability among CHFpatients. Only11.82%CHF patients reported good weight monitoring adherence.Surprisingly, for those in NYHA class Ⅲ, better weight monitoring adherence wassignificantly associated with higher CHF-related hospitalization.Part Ⅱ: At months6, we observed significant higher scores of WMQ, includingglobally and all of the four subscales (weight monitoring, WM-knowledge,WM-confidence and WM-practice) in intervention group, compared with control group (P＜0.001). With-in comparison showed that in control group, WM-practice improvedsignificantly compared with enrollment (P=0.01), while in intervention group, all of thefour subscales improved significantly. At months6,26patients (81.25%) in interventiongroup reported optimal adherence to weight monitoring, and in control group,4patients(11.76%) reported optimal adherence, suggesting the intervention can greatly improve patients’ adherence to weight monitoring (P＜0.001).The6-month weight management intervention yield significant improvement ofpatients’ cardiac function in intervention group. Patients in intervention group yieldedsignificantly less CHF-related re-hospitalization than control group during the follow-up(0.28±0.63vs.0.79±1.18, P=0.03).At months6, the global score of MLHFQ was significantly lower in interventiongroup compared with control group (P＜0.001), as well as the physical scale (P＜0.001)and the emotion scale (P=0.003). No significant improvement was observed in controlgroup at months6compared with enrollment; but in intervention group, patients reportedlower scores of MLHFQ, including both physical and emotional component (P＜0.001, P＜0.001, P＜0.001). Patients in the same NYHA class reported better quality of life inintervention group than control group. WM intervention significantly improved quality oflife of both male and female, but significant improvement in emotional component wasonly found among female patients.Conclusion: The survey indicated low level of WM ability and adherence to weightmonitoring among CHF patients. The WM intervention could increase patients’ WMability and adherence to weight monitoring, and improve patients’ prognosis andCHF-related quality of life.