Quality of life (QoL) and burden scales have proved to be useful in estimating the impact of diseases and treatments from the patient’s perspective. Yet, no data nor scales are currently available with respect to the burden associated with the low sodium diet usually prescribed in heart failure (HF) patients, despite the lack of evidence of its efficacy and the previously reported evidence for negative effects in restricted diets (e.g. gluten-free).

To develop and validate a low sodium diet burden scale in HF patients.

After a literature review and interviews with patients, 14 items were selected (coded 0-4, global score/70, higher scores reflecting higher burden) for the following domains relating to dietary habits: organization, pleasure, leisure, social life, vitality and self-rated health. The validation study was conducted in HF patients (NYHA I-IV) prospectively enrolled between 09/2012-09/2013 (H.Mondor Hospital, Cardiology Dpt, Creteil).

93 patients completed the burden scale (men 64%; mean age 63.2 [±13.3]), of whom 14% had a highly restricted low sodium diet (<3g/d), 37% moderately restricted (3-6g) and 49% mildly restricted. Median burden score was 9 (IQR 3-17; min 0-max 40); results showed an excellent acceptability of the scale (non response rates/item: 2% to 12%), excellent internal consistency (Cronbach ?=0.90; Spearman correlation coefficients between items and global score: r_s from 0.47 [appetite] to 0.81 [mental burden]; p<0.001), good convergent validity (positive correlation between the global burden score and dimensions scores from the QoL Minnesota scale: r_s=0.49 [physical dimension], 0.57 [mental], 0.52 [global]; p<0.001) and good discriminative capacity of the patients with a highly restricted diet (p=0.01; Figure next page).

These first findings demonstrate the good psychometric properties of a new burden scale and show that highly restricted salt diet is associated with high burden in HF patients.