The benefits of thermal clothing during winter in patients with heart failure : a pilot randomised controlled trial

Barnett, Adrian G., Lucas, Margaret, Platts, David, Whiting, Elizabeth, & Fraser, John F. (2013) The benefits of thermal clothing during winter in patients with heart failure : a pilot randomised controlled trial. BMJ Open, 3(4), e002799.

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Many Australian cities experience large winter increases in deaths and hospitalisations. Flu outbreaks are only part of the problem and inadequate protection from cold weather is a key independent risk factor. Better home insulation has been shown to improve health during winter, but no study has examined whether better personal insulation improves health.

Data and Methods

We ran a randomised controlled trial of thermal clothing versus usual care. Subjects with heart failure (a group vulnerable to cold) were recruited from a public hospital in Brisbane in winter and followed-up at the end of winter. Those randomised to the intervention received two thermal hats and tops and a digital thermometer. The primary outcome was the number of days in hospital, with secondary outcomes of General Practitioner (GP) visits and self-rated health.


The mean number of days in hospital per 100 winter days was 2.5 in the intervention group and 1.8 in the usual care group, with a mean difference of 0.7 (95% CI: –1.5, 5.4). The intervention group had 0.2 fewer GP visits on average (95% CI: –0.8, 0.3), and a higher self-rated health, mean improvement –0.3 (95% CI: –0.9, 0.3). The thermal tops were generally well used, but even in cold temperatures the hats were only worn by 30% of subjects.


Thermal clothes are a cheap and simple intervention, but further work needs to be done on increasing compliance and confirming the health and economic benefits of providing thermals to at-risk groups.

Impact and interest:

1 citations in Scopus
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ID Code: 63090
Item Type: Journal Article
Refereed: Yes
Keywords: temperature, winter, thermal, clothing, randomised controlled trial
DOI: 10.1136/bmjopen-2013-002799
ISSN: 2044-6055
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Environmental and Occupational Health and Safety (111705)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Copyright Owner: Copyright 2013 The Author(s)
Copyright Statement: This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.
Deposited On: 04 Oct 2013 00:33
Last Modified: 09 Oct 2013 06:45

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