title: Patient preferences for the delivery of disease management in chronic heart failure: a qualitative study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Semistructured interviews with a purposive sample of 12 CHF patients.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Centre for Applied Health Economics, School of Medicine, Griffith University, Logan, Australia. j.whitty@griffith.edu.au
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Whitty
authors.forename: Melinda J
authors.initials: MJ
authors.lastname: Carrington
authors.forename: Simon
authors.initials: S
authors.lastname: Stewart
authors.forename: Julie
authors.initials: J
authors.lastname: Holliday
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Marwick
authors.forename: Paul A
authors.initials: PA
authors.lastname: Scuffham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D019468:Disease Management; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D010865:Pilot Projects; D036301:Qualitative Research; D055815:Young Adult