Patient Preferences for the Delivery of Disease Management in Chronic Heart Failure

Abstract

Chronic heart failure (CHF) management programs (CHF-MPs) are applied in different ways including via face-to-face settings. However, we know little about consumer preferences when applying CHF-MPs via a patient's home or specialist hospital clinic. The aim of this pilot study was to explore CHF-MP characteristics that are considered desirable by patients with CHF. Semistructured interviews with a purposive sample of 12 CHF patients. Participants had a mean age of 61 (SD, 17) years, 3 were female, and the majority was of white background. Most were assessed as either functional New York Heart Association class III (n = 3) or IV (n = 6). Home- and clinic-based CHF-MPs were preferred by 5 and 7 participants, respectively. Key themes around patient preferences related to practical aspects of program delivery and social and peer support, as well as health-related benefits that translate to traditional outcomes in program evaluations. Participants identified transport, cost, and ill health as barriers to attending a clinic-based program. However, they also highlighted benefits (eg, the ability to share experiences with other patients) that may be difficult to provide with a home-based service unless specifically organized. These preliminary data suggest that patients value aspects of a program beyond those directly related to health outcomes. They also recognize a need for flexibility in program delivery, with potential preferences for home- or clinic-based programs depending largely on individual patient circumstances. More definitive studies are required to explore how best to cater for individual preferences while optimizing health outcomes.