Abstract 11516: Heart Failure Patient Experiences With a Visualized Patient-Reported Outcome Monitoring Tool to Facilitate Beta-Blocker Decision-Making in an N-of-1 Trial

Abstract

Introduction: Emerging evidence suggests that beta-blockers may not be efficacious in preventing mortality in patients with heart failure with preserved ejection fraction (HFpEF) and could worsen exercise capacity. HFpEF patients’ symptoms often overlap with medication side effects, making precise decision-making about the need for beta-blockers a challenge. Objective: Evaluate patient attitudes toward using a patient-reported outcome (PRO) monitoring tool to facilitate shared decision-making about beta-blocker use in an N-of-1 clinical trial. Methods: Eligible HFpEF patients taking a beta-blocker were recruited from a heart failure clinic. Patients alternated between taking and not taking their beta-blocker for 2-week periods, with dedicated titration time in-between. Data were ascertained through exercise assessments, weekly/bi-weekly online PRO surveys, and remote vital measurements. Average symptom scores on and off beta-blocker were presented in a visualized report to patients, intended to facilitate a discussion about continuing vs. discontinuing their beta-blocker. We interviewed patients about feedback on study procedures and agency for decision-making at baseline and study visits. Interviews were recorded and transcribed. Three study team members analyzed interviews using directed content analysis. Results: To date, 9 patients completed the intervention, and 28 interviews were completed. Most participants were female and White (89%) with an average age of 78. Participants reported that their visualized PRO results were aligned their experiences, which reinforced their use of the tool and agency in beta-blocker decision-making (Table). Conclusions: Patients found that the visualized report helped to facilitate beta-blocker shared decision-making. Future research should evaluate the utility of integrating longitudinal PRO monitoring tools into usual care to facilitate individualized decisions about medications.