Title:	Optimising Management of Patients with Heart Failure with Preserved Ejection Fraction in Primary Care (Optimise-HFpEF)
Project Description:	Heart failure (HF) accounts for 2% of NHS expenditure, and 5% of emergency hospitalisations. Patients with HF with preserved ejection fraction (HFpEF) are older, have more comorbidities, have similarly poor or worse outcomes compared to patients with reduced ejection fraction (HFrEF), and currently lack an evidence base for treatment. We hypothesise that outcomes of patients with HFpEF can be improved through optimised management and self-management of comorbidities, fluid status and lifestyle delivered in primary care in collaboration with specialists. Primary Aim: to develop a programme of optimised management by improving our understanding of needs and experiences of patients with HFpEF, clinical decision-making and management in primary care, and integrating research findings with patient and clinical expertise. Objectives: 1. Systematically review the literature on management and self-management models of care for patients with heart failure and co-morbidities. 2. Determine patient and health professionals (primary care and specialists) preferences, perspectives on burden of illness and treatment, care needed and organisation of services/support. 3. Identify patients with HFpEF in primary care and assess comorbidities and other factors, and morbidity and mortality at one year. 4. Develop an optimised programme of management for HFpEF that addresses comorbidities, self-management including lifestyle factors, burden of treatment, and transitions in care. Methods: mixed methods including Work Package 1 (WP1) a systematic review ; WP2a qualitative research involving patients and HCPs; WP2b a cohort study of 200 patients with HFpEF in primary care followed for 12 months; WP3 consensus methods (nominal groups of patients and HCPs) to develop an optimised management programme and test components for feasibility and acceptability. The House of Care, systems thinking and the concepts of burden of treatment and minimally disruptive medicine will provide theoretical frameworks for the optimised programme. The finalised programme will be piloted and trialled in a subsequent study.
Project organisation
Start date:	1st October 2017
End date:	30th June 2020
Contact person:	Professor Christi Deaton
Contact Details:	Primary Care Unit Institute of Public Health University Forvie Site, Robinson Way Cambridge Cambs CB2 0SR UK Telephone: (01223) 762561 Fax: 01223 762515 E-mail: cd531@medschl.cam.ac.uk
Collaborative:	Cambridge: Jonathan Mant, Duncan Edwards, Ian Wellwood Oxford: Richard Hobbs, Clare Taylor Manchester: Thomas Blakeman Keele: Carolyn Chew-GrahamProject Website : https://www.optimisehfpef.phpc.cam.ac.uk/
Funding information
Funding Organisation:	NIHR School for Primary Care Research
Funding Reference:	FR_14
Funding Amount:	£633,845
Further Information, References and Publications