Behavior Changein heart failure patients

Adetania Pramanik

Durga Kudtarkar

Shubhshankar M. Sankachelvi

SRD Significancesodium restricted diet• 25% of heart failure (HF) related patients were readmitted

• Limiting sodium intake is one of the ways of readmission prevention for HF patients.

• However, it is difficult for patients to understand how to manage and change their daily sodium intake

Background

Heart Failure

• Most common cause HF: coronary artery disease (narrowing the blood vessels that supply the heart)

• Conditions that contribute to HF: obesity, diabetes, smoking, hypercholesterolemia, hypertension,…

• Is a progressive, chronic disease

BackgroundFunctional classification (NYHA): Four stages of HF(ACC / AHA):

Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities.

Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion.

Class III: marked limitation of any activity; the patient is comfortable only at rest.

Class IV: any physical activity brings on discomfort and symptoms occur at rest.

Stage A: high risk for HF but no functional or structural heart disorder

Stage B: a structural heart disorder but no symptoms at any stage

Stage C: an underlying structural heart problem, but managed with medical treatment

Stage C: an underlying structural heart problem, but managed with medical

Stage D: hospital-based support, a heart transplant or palliative care.

Risk FactorsCannot be changed

Can be treated

Treatment Plan

Nutritional Diet• Sodium intake < 3,000 mg/day

Lesser HF symptoms

• What does 1500, 2300 or 3000 mg/day mean?

• Low salt doesn’t mean low sodium

SRDsodium restricted diet• Understanding sodium content of food

• Lack of food selection

• Food preparation habits

• Fast foods and convenience products

• Understanding the symptoms of HF

• Literacy

• Co-morbidities

• Depression: worse self-care & poorer prognosis

Helpless

Acceptance

Proactive

SRDsodium restricted diet

Education and Motivation

Fun

Meaningful

Can do vs Cannot do

The Problem • How can we assist HF

patients in understanding their appropriate daily sodium intake and motivate them to bring about a behavior change?

informative hospital food +

interactive packaging

Solution 1

Solution 1informative hospital food

Solution 1interactive packaging

Related Work

• How to Nudge In Situ: Designing Lambent Devices to deliver Information Salience in Supermarkets

• http://mapawatt.com/2009/10/07/list-of-energy-monitoring-tools/

• http://daeyoon-scale-industrial-co.tradenote.net/images/users/000/195/393/products_images/567029.jpg

Solution 2Trust Labels, not taste buds

=

Difficult to follow everyday

Solution 2Apps to monitor sodium intake

www.nal.usda.gov/fnic/foodcomp/search/

Milk, fluid, 1% fat, without added vitamin A and vitamin D

Magnesium, Mg

mg 11 22 0.093

Phosphorus, P

mg 95 21 0.368

Potassium, K

mg 150 11 1.088

Sodium, Na mg 44 23 0.760

Zinc, Zn mg 0.42 11 0.003

Nutrient UnitsValue per100 grams

Numberof DataPoints

Std.Error

on-line global nutrition information

Solution 2App architecture design

Input: QR code or text

Mobile device

Web server USDA Database

Scan QR code

Client server communication

Data retrieval

Intuitive output

Solution 3Dietary Recall systems

Track daily sodium consumption and provide feedback.

Questionnaire TimingFrequently consumed items

Quantity

Solution 4Food recommendations

Thanks