Changes in Thirst Intensity During Optimization of Heart Failure Medical Therapy by Nurses at the Outpatient Clinic

Nana Waldréus, Robert G. Hahn, Patrik Lyngå, Martje H. L. van der Wal, Ewa Hägglund, Tiny Jaarsma

Thirst can be aggravated in patients with heart failure (HF), and optimization of HF medication can have positive impact on thirst. The aims of this study were to describe changes in thirst intensity and to determine factors associated with high thirst intensity during optimization of HF medication. Patients with HF (N = 66) who were referred to an HF clinic for up-titration of HF medication were included. Data were collected during the first visit to the clinic and at the end of the treatment program. Data were dichotomized by the median visual analog scale score for thirst, dividing patients into 2 groups: low thirst intensity (0-20 mm) and high thirst intensity (>20 mm on a visual analog scale of 0-100 mm). In total, 67% of the patients reported a higher thirst intensity after the HF up-titration program. There was no difference in thirst intensity between the patients who reached target doses and those who did not. Plasma urea level (odds ratio, 1.33; 95% confidence interval, 1.07-1.65) and fluid restriction (odds ratio, 6.25; 95% confidence interval, 1.90-20.5) were independently associated with high thirst intensity in patients with HF. Thirst intensity increased in two-thirds of the patients during a time period of optimization of HF medication. Fluid restriction and plasma urea levels were associated with high thirst intensity.