Keywords

heart failure, management program, patient preferences, service delivery

 

Authors

  1. Whitty, Jennifer A. PhD
  2. Carrington, Melinda J. PhD
  3. Stewart, Simon PhD
  4. Holliday, Julie MHSc, BN
  5. Marwick, Thomas H. MBBS, PhD, FRACP
  6. Scuffham, Paul A. PhD

Abstract

Background and Research Objective: Chronic heart failure (CHF) management programs (CHF-MPs) are applied in different ways including via face-to-face settings. However, we know little about consumer preferences when applying CHF-MPs via a patient's home or specialist hospital clinic. The aim of this pilot study was to explore CHF-MP characteristics that are considered desirable by patients with CHF.

 

Subject and Methods: Semistructured interviews with a purposive sample of 12 CHF patients.

 

Results: Participants had a mean age of 61 (SD, 17) years, 3 were female, and the majority was of white background. Most were assessed as either functional New York Heart Association class III (n = 3) or IV (n = 6). Home- and clinic-based CHF-MPs were preferred by 5 and 7 participants, respectively. Key themes around patient preferences related to practical aspects of program delivery and social and peer support, as well as health-related benefits that translate to traditional outcomes in program evaluations. Participants identified transport, cost, and ill health as barriers to attending a clinic-based program. However, they also highlighted benefits (eg, the ability to share experiences with other patients) that may be difficult to provide with a home-based service unless specifically organized.

 

Conclusions: These preliminary data suggest that patients value aspects of a program beyond those directly related to health outcomes. They also recognize a need for flexibility in program delivery, with potential preferences for home- or clinic-based programs depending largely on individual patient circumstances. More definitive studies are required to explore how best to cater for individual preferences while optimizing health outcomes.