Optimising management of patients with heart failure with preserved ejection fraction in primary care (OPTIMISE-HFpEF): Rationale and protocol for a multi-method study

Faye Forsyth; Jonathan Mant; Clare J. Taylor; F. D. Richard Hobbs; Carolyn A. Chew-Graham; Thomas Blakeman; Emma Sowden; Aaron Long; Muhammad Zakir Hossain; Duncan Edwards; Christi Deaton

doi:10.3399/BJGPOPEN19X101675

Optimising management of patients with heart failure with preserved ejection fraction in primary care (OPTIMISE-HFpEF): Rationale and protocol for a multi-method study

Faye Forsyth, Jonathan Mant, Clare J. Taylor, F. D. Richard Hobbs, Carolyn A. Chew-Graham, Thomas Blakeman, Emma Sowden, Aaron Long, Muhammad Zakir Hossain, Duncan Edwards, Christi Deaton^*

^*Corresponding author for this work

Applied Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Heart failure with preserved ejection fraction (HFpEF) is less well understood than heart failure with reduced ejection fraction (HFrEF), with greater diagnostic difficulty and management uncertainty. Aim: The primary aim is to develop an optimised programme that is informed by the needs and experiences of people with HFpEF and healthcare providers. This article presents the rationale and protocol for the Optimising Management of Patients with Heart Failure with Preserved Ejection Fraction in Primary Care (OPTIMISE-HFpEF) research programme. Design & setting: This is a multi-method programme of research conducted in the UK. Method: OPTIMISE-HFpEF is a multi-site programme of research with three distinct work packages (WPs). WP1 is a systematic review of heart failure disease management programmes (HF-DMPs) tested in patients with HFpEF. WP2 has three components (a, b, c) that enable the characteristics, needs, and experiences of people with HFpEF, their carers, and healthcare providers to be understood. Qualitative enquiry (WP2a) with patients and providers will be conducted in three UK sites exploring patient and provider perspectives, with an additional qualitative component (WP2c) in one site to focus on transitions in care and carer perspectives. A longitudinal cohort study (WP2b), recruiting from four UK sites, will allow patients to be characterised and their illness trajectory observed across 1 year of follow-up. Finally, WP3 will synthesise the findings and conduct work to gain consensus on how best to identify and manage this patient group. Results: Results from the four work packages will be synthesised to produce a summary of key learning points and possible solutions (optimised programme) which will be presented to a broad spectrum of stakeholders to gain consensus on a way forward. Conclusion: HFpEF is often described as the greatest unmet need in cardiology. The OPTIMISE-HFpEF programme aims to address this need in primary care, which is arguably the most appropriate setting for managing HFpEF.

Original language	English
Pages (from-to)	1-12
Number of pages	12
Journal	BJGP Open
Volume	3
Issue number	4
DOIs	https://doi.org/10.3399/BJGPOPEN19X101675
Publication status	Published - 1 Dec 2019

Bibliographical note

Funding Information:
This work is independent research funded by the National Institute for Health Research School for Primary Care Research Grant (reference number 384). The views expressed are those of the author(s) and not necessarily those of the NIHR, the NHS, or the Department of Health.

Funding Information:
FDRH acknowledges his part-funding from the National Institute for Health Research (NIHR) School for Primary Care Research, the NIHR Collaboration for Leadership in Health Research and Care (CLARHC) Oxford, the NIHR Oxford Biomedical Research Centre (BRC), and the NIHR Oxford Medtech and In-Vitro Diagnostics Co-operative (MIC).

Funding Information:
Recruitment support for WP2a and WP2b was provided by the NIHR Clinical Research Network. WP2b research was carried out at/supported by the NIHR Cambridge Clinical Research Facility Facilities and the Oxford Cardiovascular Clinical Research Centre.

Publisher Copyright:
© 2019 This article is Open Access.

ASJC Scopus subject areas

Family Practice

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10.3399/BJGPOPEN19X101675

Cite this

Forsyth, F., Mant, J., Taylor, C. J., Richard Hobbs, F. D., Chew-Graham, C. A., Blakeman, T., Sowden, E., Long, A., Hossain, M. Z., Edwards, D., & Deaton, C. (2019). Optimising management of patients with heart failure with preserved ejection fraction in primary care (OPTIMISE-HFpEF): Rationale and protocol for a multi-method study. BJGP Open, 3(4), 1-12. https://doi.org/10.3399/BJGPOPEN19X101675

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title = "Optimising management of patients with heart failure with preserved ejection fraction in primary care (OPTIMISE-HFpEF): Rationale and protocol for a multi-method study",

abstract = "Background: Heart failure with preserved ejection fraction (HFpEF) is less well understood than heart failure with reduced ejection fraction (HFrEF), with greater diagnostic difficulty and management uncertainty. Aim: The primary aim is to develop an optimised programme that is informed by the needs and experiences of people with HFpEF and healthcare providers. This article presents the rationale and protocol for the Optimising Management of Patients with Heart Failure with Preserved Ejection Fraction in Primary Care (OPTIMISE-HFpEF) research programme. Design & setting: This is a multi-method programme of research conducted in the UK. Method: OPTIMISE-HFpEF is a multi-site programme of research with three distinct work packages (WPs). WP1 is a systematic review of heart failure disease management programmes (HF-DMPs) tested in patients with HFpEF. WP2 has three components (a, b, c) that enable the characteristics, needs, and experiences of people with HFpEF, their carers, and healthcare providers to be understood. Qualitative enquiry (WP2a) with patients and providers will be conducted in three UK sites exploring patient and provider perspectives, with an additional qualitative component (WP2c) in one site to focus on transitions in care and carer perspectives. A longitudinal cohort study (WP2b), recruiting from four UK sites, will allow patients to be characterised and their illness trajectory observed across 1 year of follow-up. Finally, WP3 will synthesise the findings and conduct work to gain consensus on how best to identify and manage this patient group. Results: Results from the four work packages will be synthesised to produce a summary of key learning points and possible solutions (optimised programme) which will be presented to a broad spectrum of stakeholders to gain consensus on a way forward. Conclusion: HFpEF is often described as the greatest unmet need in cardiology. The OPTIMISE-HFpEF programme aims to address this need in primary care, which is arguably the most appropriate setting for managing HFpEF.",

author = "Faye Forsyth and Jonathan Mant and Taylor, {Clare J.} and {Richard Hobbs}, {F. D.} and Chew-Graham, {Carolyn A.} and Thomas Blakeman and Emma Sowden and Aaron Long and Hossain, {Muhammad Zakir} and Duncan Edwards and Christi Deaton",

note = "Funding Information: This work is independent research funded by the National Institute for Health Research School for Primary Care Research Grant (reference number 384). The views expressed are those of the author(s) and not necessarily those of the NIHR, the NHS, or the Department of Health. Funding Information: FDRH acknowledges his part-funding from the National Institute for Health Research (NIHR) School for Primary Care Research, the NIHR Collaboration for Leadership in Health Research and Care (CLARHC) Oxford, the NIHR Oxford Biomedical Research Centre (BRC), and the NIHR Oxford Medtech and In-Vitro Diagnostics Co-operative (MIC). Funding Information: Recruitment support for WP2a and WP2b was provided by the NIHR Clinical Research Network. WP2b research was carried out at/supported by the NIHR Cambridge Clinical Research Facility Facilities and the Oxford Cardiovascular Clinical Research Centre. Publisher Copyright: {\textcopyright} 2019 This article is Open Access.",

year = "2019",

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doi = "10.3399/BJGPOPEN19X101675",

language = "English",

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Forsyth, F, Mant, J, Taylor, CJ, Richard Hobbs, FD, Chew-Graham, CA, Blakeman, T, Sowden, E, Long, A, Hossain, MZ, Edwards, D & Deaton, C 2019, 'Optimising management of patients with heart failure with preserved ejection fraction in primary care (OPTIMISE-HFpEF): Rationale and protocol for a multi-method study', BJGP Open, vol. 3, no. 4, pp. 1-12. https://doi.org/10.3399/BJGPOPEN19X101675

TY - JOUR

T1 - Optimising management of patients with heart failure with preserved ejection fraction in primary care (OPTIMISE-HFpEF)

T2 - Rationale and protocol for a multi-method study

AU - Forsyth, Faye

AU - Mant, Jonathan

AU - Taylor, Clare J.

AU - Richard Hobbs, F. D.

AU - Chew-Graham, Carolyn A.

AU - Blakeman, Thomas

AU - Sowden, Emma

AU - Long, Aaron

AU - Hossain, Muhammad Zakir

AU - Edwards, Duncan

AU - Deaton, Christi

N1 - Funding Information: This work is independent research funded by the National Institute for Health Research School for Primary Care Research Grant (reference number 384). The views expressed are those of the author(s) and not necessarily those of the NIHR, the NHS, or the Department of Health. Funding Information: FDRH acknowledges his part-funding from the National Institute for Health Research (NIHR) School for Primary Care Research, the NIHR Collaboration for Leadership in Health Research and Care (CLARHC) Oxford, the NIHR Oxford Biomedical Research Centre (BRC), and the NIHR Oxford Medtech and In-Vitro Diagnostics Co-operative (MIC). Funding Information: Recruitment support for WP2a and WP2b was provided by the NIHR Clinical Research Network. WP2b research was carried out at/supported by the NIHR Cambridge Clinical Research Facility Facilities and the Oxford Cardiovascular Clinical Research Centre. Publisher Copyright: © 2019 This article is Open Access.

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Background: Heart failure with preserved ejection fraction (HFpEF) is less well understood than heart failure with reduced ejection fraction (HFrEF), with greater diagnostic difficulty and management uncertainty. Aim: The primary aim is to develop an optimised programme that is informed by the needs and experiences of people with HFpEF and healthcare providers. This article presents the rationale and protocol for the Optimising Management of Patients with Heart Failure with Preserved Ejection Fraction in Primary Care (OPTIMISE-HFpEF) research programme. Design & setting: This is a multi-method programme of research conducted in the UK. Method: OPTIMISE-HFpEF is a multi-site programme of research with three distinct work packages (WPs). WP1 is a systematic review of heart failure disease management programmes (HF-DMPs) tested in patients with HFpEF. WP2 has three components (a, b, c) that enable the characteristics, needs, and experiences of people with HFpEF, their carers, and healthcare providers to be understood. Qualitative enquiry (WP2a) with patients and providers will be conducted in three UK sites exploring patient and provider perspectives, with an additional qualitative component (WP2c) in one site to focus on transitions in care and carer perspectives. A longitudinal cohort study (WP2b), recruiting from four UK sites, will allow patients to be characterised and their illness trajectory observed across 1 year of follow-up. Finally, WP3 will synthesise the findings and conduct work to gain consensus on how best to identify and manage this patient group. Results: Results from the four work packages will be synthesised to produce a summary of key learning points and possible solutions (optimised programme) which will be presented to a broad spectrum of stakeholders to gain consensus on a way forward. Conclusion: HFpEF is often described as the greatest unmet need in cardiology. The OPTIMISE-HFpEF programme aims to address this need in primary care, which is arguably the most appropriate setting for managing HFpEF.

AB - Background: Heart failure with preserved ejection fraction (HFpEF) is less well understood than heart failure with reduced ejection fraction (HFrEF), with greater diagnostic difficulty and management uncertainty. Aim: The primary aim is to develop an optimised programme that is informed by the needs and experiences of people with HFpEF and healthcare providers. This article presents the rationale and protocol for the Optimising Management of Patients with Heart Failure with Preserved Ejection Fraction in Primary Care (OPTIMISE-HFpEF) research programme. Design & setting: This is a multi-method programme of research conducted in the UK. Method: OPTIMISE-HFpEF is a multi-site programme of research with three distinct work packages (WPs). WP1 is a systematic review of heart failure disease management programmes (HF-DMPs) tested in patients with HFpEF. WP2 has three components (a, b, c) that enable the characteristics, needs, and experiences of people with HFpEF, their carers, and healthcare providers to be understood. Qualitative enquiry (WP2a) with patients and providers will be conducted in three UK sites exploring patient and provider perspectives, with an additional qualitative component (WP2c) in one site to focus on transitions in care and carer perspectives. A longitudinal cohort study (WP2b), recruiting from four UK sites, will allow patients to be characterised and their illness trajectory observed across 1 year of follow-up. Finally, WP3 will synthesise the findings and conduct work to gain consensus on how best to identify and manage this patient group. Results: Results from the four work packages will be synthesised to produce a summary of key learning points and possible solutions (optimised programme) which will be presented to a broad spectrum of stakeholders to gain consensus on a way forward. Conclusion: HFpEF is often described as the greatest unmet need in cardiology. The OPTIMISE-HFpEF programme aims to address this need in primary care, which is arguably the most appropriate setting for managing HFpEF.

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Optimising management of patients with heart failure with preserved ejection fraction in primary care (OPTIMISE-HFpEF): Rationale and protocol for a multi-method study

Abstract

Bibliographical note

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