Challenges in the management of people with heart failure with preserved ejection fraction (HFpEF) in primary care: A qualitative study of general practitioner perspectives.
Chew-Graham, Carolyn A
MetadataShow full item record
Hossain, M. Z., Chew-Graham, C. A., Sowden, E., Blakeman, T., Wellwood, I., Tierney, S., & Deaton, C. (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 Illn, 18 (2), 410-425. https://doi.org/10.1177/1742395320983871
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.
ARTICLES, General practitioners, primary care, heart failure, HFpEF, qualitative methods
NIHR School for Primary Care Research
National Institute for Health Research (NIHR) (via University of Oxford) (SPCR R14)
External DOI: https://doi.org/10.1177/1742395320983871
This record's URL: https://www.repository.cam.ac.uk/handle/1810/337788