Challenges in the management of people with heart failure with preserved ejection fraction (HFpEF) in primary care : A qualitative study of general practitioner perspectives

Journal article


Hossain, Muhammad Z., Chew-Graham, Carolyn A., Sowden, Emma, Blakeman, Thomas, Wellwood, Ian, Tierney, Stephanie and Deaton, Christi. (2022). Challenges in the management of people with heart failure with preserved ejection fraction (HFpEF) in primary care : A qualitative study of general practitioner perspectives. Chronic Illness. 18(2), pp. 410-425. https://doi.org/10.1177/1742395320983871
AuthorsHossain, Muhammad Z., Chew-Graham, Carolyn A., Sowden, Emma, Blakeman, Thomas, Wellwood, Ian, Tierney, Stephanie and Deaton, Christi
Abstract

Objectives
To explore the perspectives of general practitioners (GPs) on the identification and management of people, including those from ethnic minority groups, with Heart Failure with Preserved Ejection Fraction (HFpEF).

Methods
Qualitative study. Semi-structured, face-to-face or telephone interviews and focus groups were conducted with 35 GPs in England, which were audio-recorded and transcribed verbatim. Framework analysis was used to manage and interpret data.

Results
Themes presented reflect four inter-related challenges: GPs’ 1) lack of understanding HFpEF, impacting on 2) difficulties in communicating the diagnosis, leading to 3) uncertainty in managing people with HFpEF, further hindered by (4) discontinuity across the primary/secondary interface. All were considered more challenging by GPs when managing people from different cultures and languages.

Discussion
HFpEF is not well understood by GPs, leading to diagnostic difficulty, management uncertainty and potential inequity in care offered. People with HFpEF are seen as complex, with multiple long-term conditions and requiring personalised care. Challenges in their management occur across the healthcare system. This study has identified learning needs for GPs around identification and on-going support for people with HFpEF in primary care. It will contribute to the development of more flexible and patient-centred pathways across the primary/secondary care interface.

Keywordsgeneral practitioners; primary care; heart failure; HFpEF; qualitative methods
Year2022
JournalChronic Illness
Journal citation18 (2), pp. 410-425
PublisherSAGE Publications
ISSN1742-3953
Digital Object Identifier (DOI)https://doi.org/10.1177/1742395320983871
PubMed ID33401942
Scopus EID2-s2.0-85098869950
PubMed Central IDPMC9163769
Open accessPublished as ‘gold’ (paid) open access
Page range410-425
FunderNational Institute for Health Research (NIHR)
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online05 Jan 2021
Publication process dates
Accepted09 Dec 2020
Deposited01 Dec 2022
Grant IDPrimary Care Research Grant 384
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