Qualitative Analysis of Patient Decisional Needs for Medications to Treat Heart Failure

Turgeon, RD; Fernando, S; Bains, M; Code, J; Hawkins, NM; Koshman, S; Straatman, L; Toma, M; Virani, SA; MacDonald, BJ; Snow, ME

doi:10.1161/circheartfailure.123.011445

Heart failure & cardiomyopathies

Qualitative Analysis of Patient Decisional Needs for Medications to Treat Heart Failure

Circ Heart FailPublished 6 Apr 2024Qualitative study

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Authors' conclusion

Patients with HFrEF have several decisional needs, which are consistent with those that may respond to decision aids.

Study context

Population: Patients with HFrEF and heart failure (HF) clinicians, Canada
Participants: 15 vs 12

Comparison: Patients vs Clinicians
Patientsn = 15
Cliniciansn = 12
Outcome: Patients' decisional needs when considering HFrEF medication options

Methodological detailssemi-structured interviews, inductive thematic analysis

Semi-structured interviews
Inductive thematic analysis

Main finding

As reported in the abstract

Themes in HFrEF pharmacotherapy decision-making

Six themes and associated subthemes emerged: 6

Reference

Authors: Turgeon RD, Fernando S, Bains M, Code J, Hawkins NM, Koshman S, et al.
All 11 authors
Turgeon RD, Fernando S, Bains M, Code J, Hawkins NM, Koshman S, Straatman L, Toma M, Virani SA, MacDonald BJ, Snow ME
Journal: Circulation: Heart Failure
Published: 6 Apr 2024
DOI: 10.1161/circheartfailure.123.011445
PubMed: 38581405

Country: Canada
Topic: Heart failure & cardiomyopathies

Group definitions

Patients: patients with HFrEF from 2 Canadian ambulatory HF clinics
Clinicians: from Canadian HF guideline panels, HF clinics and Canadian HF Society membership

Key notes

Patient decisional needs: lack of awareness of a choice or options, difficult decision timing and stage, information overload, inadequate motivation, support and resources
Patients' decisional conflict varied substantially, driven by unclear trade-offs

More notes

Treatment attribute preferences: patients focused on both benefits and downsides; clinicians centred discussion on benefits
Quality of life: patients' definition depended on pre-HF activity; most adapted daily activities to manage HF
Shared decision-making process: clinicians described a process more akin to informed consent
Decision support: multimedia decision aids, virtual appointments and primary-care comanagement as potential enablers of shared decision-making

Original publication

Qualitative Analysis of Patient Decisional Needs for Medications to Treat Heart Failure. Circ Heart Fail. Published 6 April 2024. doi:10.1161/circheartfailure.123.011445

Read the original article ↗

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