Hossain, MZ ORCID: https://orcid.org/0000-0002-4939-1597, Chew-Graham, CA ORCID: https://orcid.org/0000-0002-9722-9981, Sowden, E, Blakemen, T, Wellwood, I, Tierney, S and Deaton, C (2020) Challenges in the management of people with heart failure with preserved ejection fraction (HFpEF) in primary care: a qualitative study of general practitioner perspectives. Chronic Illness. (In Press)

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Abstract

Objectives: To explore the perspectives of general practitioners (GPs) on the identification and management of people, including those from ethnic minority groups, with Heart Failure with Preserved Ejection Fraction (HFpEF). Methods: Qualitative study. Semi-structured, face-to-face or telephone interviews and focus groups were conducted with 35 GPs in England, which were audio-recorded and transcribed verbatim. Framework analysis was used to manage and interpret data. Results: Themes presented reflect four inter-related challenges: GPs’ 1) lack of understanding HFpEF, impacting on 2) difficulties in communicating the diagnosis, leading to 3) uncertainty in managing people with HFpEF, further hindered by (4) discontinuity across the primary/secondary interface. All were considered more challenging by GPs when managing people from different cultures and languages. Discussion: HFpEF is not well understood by GPs, leading to diagnostic difficulty, management uncertainty and potential inequity in care offered. People with HFpEF are seen as complex, with multiple long-term conditions and requiring personalised care. Challenges in their management occur across the healthcare system. This study has identified learning needs for GPs around identification and on-going support for people with HFpEF in primary care. It will contribute to the development of more flexible and patient-centred pathways across the primary/secondary care interface.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Sage Publications at https://uk.sagepub.com/en-gb/eur/journal/chronic-illness. Please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: General Practitioners, Primary Care, Heart Failure, HFpEF, Qualitative Methods
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Depositing User: Symplectic
Date Deposited: 18 Nov 2020 11:37
Last Modified: 18 Nov 2020 11:37
URI: https://eprints.keele.ac.uk/id/eprint/8900

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