Diagnosing and managing patients with heart failure with preserved ejection fraction: a consensus survey
Aim As heart failure (HF) with preserved ejection fraction (HFpEF) prevalence increases, it remains frequently underdiagnosed and poorly managed. Recent positive pharmacological trials have increased interest in HFpEF but challenges of diagnosis and management remain. The survey aim was to examine c...
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/12/e092993.full |
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| author | Christi Deaton Robin Fox Ian Wellwood Carolyn Chew-Graham Katherine Brown Sharon Dixon Thomas Blakeman Alistair Brown Julie Smith Nick Thomas Adam Jones Basilio Hernandez-Diaz Christopher Keast Heather Rutter Kyle Knox Matthew Gaw Nick Wooding Christine A'Court Hannah Swayze Helen Ashdown Victoria Glover Rosalynn Austin Eva Khair Muhammad Zakir Hossain Emma Sowden Faye Forsyth Mollika Chakravorty Sophie Maclachlan Edward Kane Jessica Odone Natasha Thorley Susana Borja-Boluda Muhammed Hossain John Sharpley Brain Gordon Joanna Taffe Aaron Long Affan Aziz Chris Schramm Sine MacDonald Helena Papworth Craig Needs David Cronk Chris Newark Duncan Blake Amman Basuita Emma Gayton Jonathan Crawshaw Rachael Ayerst Shamila Wanninayake Elisabetta Angeleri-Rand |
| author_facet | Christi Deaton Robin Fox Ian Wellwood Carolyn Chew-Graham Katherine Brown Sharon Dixon Thomas Blakeman Alistair Brown Julie Smith Nick Thomas Adam Jones Basilio Hernandez-Diaz Christopher Keast Heather Rutter Kyle Knox Matthew Gaw Nick Wooding Christine A'Court Hannah Swayze Helen Ashdown Victoria Glover Rosalynn Austin Eva Khair Muhammad Zakir Hossain Emma Sowden Faye Forsyth Mollika Chakravorty Sophie Maclachlan Edward Kane Jessica Odone Natasha Thorley Susana Borja-Boluda Muhammed Hossain John Sharpley Brain Gordon Joanna Taffe Aaron Long Affan Aziz Chris Schramm Sine MacDonald Helena Papworth Craig Needs David Cronk Chris Newark Duncan Blake Amman Basuita Emma Gayton Jonathan Crawshaw Rachael Ayerst Shamila Wanninayake Elisabetta Angeleri-Rand |
| collection | DOAJ |
| description | Aim As heart failure (HF) with preserved ejection fraction (HFpEF) prevalence increases, it remains frequently underdiagnosed and poorly managed. Recent positive pharmacological trials have increased interest in HFpEF but challenges of diagnosis and management remain. The survey aim was to examine consensus between primary and secondary care providers regarding HFpEF diagnosis and management.Methods As part of a larger programme of work, survey questions were developed in an online format and piloted with healthcare providers (HCPs). The survey link was distributed via professional networks and social media. Analysis included frequencies of responses, comparison by main professional groups and thematic analysis free-text responses. A virtual workshop of HCPs was conducted to discuss and refine survey findings.Results HCPs (n=66) across the UK participated: 19 general practitioners (GPs), 20 HF specialist nurses (HFSN), 17 cardiologists and 10 others. Consensus was high (92%) that diagnosing the type of HF was very important and most favoured inclusion of HFpEF in Quality Outcome Framework indicators. No clear consensus was reached that ongoing management should be in primary care (47.5% of GPs, 35% of HFSN and 31.3% of cardiologists ‘somewhat agreed’). Opinions differed between GPs (52.3)% and specialists (HFSN 80% and cardiologists 81.3%) for practice nurses to be upskilled and assume HFpEF management. No HCPs reported any level of disagreement for HFSN management of HFpEF. Free-text comments highlighted resource barriers to HFpEF diagnosis and management and confirmed the need to develop better HFpEF services.Conclusions Consensus was reached regarding importance of diagnosing HFpEF, but agreement on methods and responsibilities for diagnosis and management varied. Free-text comments identified HCPs concerns related to overwhelmed primary and secondary care services and lack of sufficient resources to meet existing patient demands. Creation of collaborative care pathways is needed to support the increasing number of older patients with HFpEF.Trial registration number ClinicalTrials. gov (reference number: NCT03617848). |
| format | Article |
| id | doaj-art-f39d064ea76d441da9064e2091046d4d |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-f39d064ea76d441da9064e2091046d4d2025-01-14T19:30:11ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-092993Diagnosing and managing patients with heart failure with preserved ejection fraction: a consensus survey Christi Deaton0Robin FoxIan Wellwood1Carolyn Chew-Graham2Katherine BrownSharon DixonThomas Blakeman3Alistair BrownJulie SmithNick ThomasAdam JonesBasilio Hernandez-DiazChristopher KeastHeather RutterKyle KnoxMatthew GawNick WoodingChristine A'CourtHannah SwayzeHelen AshdownVictoria GloverRosalynn Austin4Eva Khair5Muhammad Zakir Hossain6Emma Sowden7Faye Forsyth8Mollika ChakravortySophie MaclachlanEdward KaneJessica OdoneNatasha ThorleySusana Borja-BoludaMuhammed HossainJohn SharpleyBrain GordonJoanna TaffeAaron LongAffan AzizChris SchrammSine MacDonaldHelena PapworthCraig NeedsDavid CronkChris NewarkDuncan BlakeAmman BasuitaEmma GaytonJonathan CrawshawRachael AyerstShamila WanninayakeElisabetta Angeleri-Rand3 Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UKPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK7 School of Medicine, Keele University, Newcastle-under-Lyme, UK5 University of Manchester, Manchester, UK1 Department of Public Health, University of Stavanger, Stavanger, Norway3 Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK6 Birmingham City University, Birmingham, UK5 University of Manchester, Manchester, UK8 Department of Public Health and Primary Care, KU Leuven, Leuven, BelgiumAim As heart failure (HF) with preserved ejection fraction (HFpEF) prevalence increases, it remains frequently underdiagnosed and poorly managed. Recent positive pharmacological trials have increased interest in HFpEF but challenges of diagnosis and management remain. The survey aim was to examine consensus between primary and secondary care providers regarding HFpEF diagnosis and management.Methods As part of a larger programme of work, survey questions were developed in an online format and piloted with healthcare providers (HCPs). The survey link was distributed via professional networks and social media. Analysis included frequencies of responses, comparison by main professional groups and thematic analysis free-text responses. A virtual workshop of HCPs was conducted to discuss and refine survey findings.Results HCPs (n=66) across the UK participated: 19 general practitioners (GPs), 20 HF specialist nurses (HFSN), 17 cardiologists and 10 others. Consensus was high (92%) that diagnosing the type of HF was very important and most favoured inclusion of HFpEF in Quality Outcome Framework indicators. No clear consensus was reached that ongoing management should be in primary care (47.5% of GPs, 35% of HFSN and 31.3% of cardiologists ‘somewhat agreed’). Opinions differed between GPs (52.3)% and specialists (HFSN 80% and cardiologists 81.3%) for practice nurses to be upskilled and assume HFpEF management. No HCPs reported any level of disagreement for HFSN management of HFpEF. Free-text comments highlighted resource barriers to HFpEF diagnosis and management and confirmed the need to develop better HFpEF services.Conclusions Consensus was reached regarding importance of diagnosing HFpEF, but agreement on methods and responsibilities for diagnosis and management varied. Free-text comments identified HCPs concerns related to overwhelmed primary and secondary care services and lack of sufficient resources to meet existing patient demands. Creation of collaborative care pathways is needed to support the increasing number of older patients with HFpEF.Trial registration number ClinicalTrials. gov (reference number: NCT03617848).https://bmjopen.bmj.com/content/14/12/e092993.full |
| spellingShingle | Christi Deaton Robin Fox Ian Wellwood Carolyn Chew-Graham Katherine Brown Sharon Dixon Thomas Blakeman Alistair Brown Julie Smith Nick Thomas Adam Jones Basilio Hernandez-Diaz Christopher Keast Heather Rutter Kyle Knox Matthew Gaw Nick Wooding Christine A'Court Hannah Swayze Helen Ashdown Victoria Glover Rosalynn Austin Eva Khair Muhammad Zakir Hossain Emma Sowden Faye Forsyth Mollika Chakravorty Sophie Maclachlan Edward Kane Jessica Odone Natasha Thorley Susana Borja-Boluda Muhammed Hossain John Sharpley Brain Gordon Joanna Taffe Aaron Long Affan Aziz Chris Schramm Sine MacDonald Helena Papworth Craig Needs David Cronk Chris Newark Duncan Blake Amman Basuita Emma Gayton Jonathan Crawshaw Rachael Ayerst Shamila Wanninayake Elisabetta Angeleri-Rand Diagnosing and managing patients with heart failure with preserved ejection fraction: a consensus survey BMJ Open |
| title | Diagnosing and managing patients with heart failure with preserved ejection fraction: a consensus survey |
| title_full | Diagnosing and managing patients with heart failure with preserved ejection fraction: a consensus survey |
| title_fullStr | Diagnosing and managing patients with heart failure with preserved ejection fraction: a consensus survey |
| title_full_unstemmed | Diagnosing and managing patients with heart failure with preserved ejection fraction: a consensus survey |
| title_short | Diagnosing and managing patients with heart failure with preserved ejection fraction: a consensus survey |
| title_sort | diagnosing and managing patients with heart failure with preserved ejection fraction a consensus survey |
| url | https://bmjopen.bmj.com/content/14/12/e092993.full |
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