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

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.

Citation

Chew-Graham. (2021). 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, https://doi.org/10.1177/1742395320983871

• Acceptance Date: Nov 10, 2020
• Publication Date: Jan 5, 2021
• Journal: Chronic Illness
• Print ISSN: 1742-3953
• Publisher: SAGE Publications
• DOI: https://doi.org/10.1177/1742395320983871
• Keywords: General Practitioners, Primary Care, Heart Failure, HFpEF, Qualitative Methods
• Publisher URL: https://doi.org/10.1177/1742395320983871