Feasibility and acceptability of using a patient reported outcome measure (OxFAB) to help patients with heart failure to recognise and communicate worsening symptoms to specialist nurses

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): General Nursing Council for England and Wales Trust Background The incidence of Heart Failure (HF) is increasing. Breathlessness and fatigue are symptoms that signal clinical deterioration. However, patients often do not recognise worsening symptoms. This can lead to avoidable hospital admission. We developed with patients a validated tool to evaluate fatigue and breathlessness (OxFAB) in patients with HF but had not established its acceptability and feasibility in clinical practice. Purpose To evaluate the feasibility and acceptability of OxFAB as a tool to optimise patient-specialist nurse communication of symptoms of fatigue and breathlessness. Methods A multi-method feasibility study conducted in HF nurse specialist clinics at two sites in England, between January 2022 and September 2022. Participants completed the tool in the clinics at 2 time points 4 to 7 weeks apart. The tool asked for symptom assessment over the previous 2 weeks. Acceptability was determined through qualitative interviews and adherence to OxFAB at the 2 time points. Feasibility was determined through questionnaire completion rates and qualitative interviews. Results Thirty-five patients and three HF nurse specialists completed the study. Nurse-led HF clinics were conducted either by telephone consultation remotely or face to face within the hospital setting. Over half the patient sample were male (58%), and 66% of the patients had HF with reduced ejection fraction, 86% NYHA Class II-III, age (µ68.5 years-SD 12.55) years. Eighty-one percent completed OxFAB in µ7.49 minutes (time-point 1) and µ6.59-mins (time-point 2). Interview data suggested that OxFAB was easy to complete, relevant and optimised symptom communication. Conclusion This feasibility study demonstrated OxFAB was acceptable and feasible in clinical practice to optimise patients-health professional communication of HF symptoms.