What helps or hinders GPs and nurses discussing physical activity with patients with heart failure, and referring patients as appropriate to community exercise resources?
Abstract - The Problem
Nearly 1 million people in the UK live with heart failure (HF). Most people diagnosed with HF are managed in primary care. Physical activity (PA) can increase wellbeing, reduce hospitalisation and improve mortality rates for patients with HF (PWHF). Studies indicate that PWHF want community health care practitioners’ reassurance and guidance about PA, but practitioners may be unsure what advice to give or where to refer patients. This study sets out to understand more fully the experiences of primary care healthcare practitioners in discussing PA with PWHF, and the barriers and enablers to doing so.
Abstract - The Approach
Qualitative interviews with healthcare practitioners in primary care. Interviewees were recruited through the NIHR Research Delivery Network in 5 English regions. We used purposive sampling to achieve a range of practice location, area deprivation level, professional role and post-qualification experience. Ethical approval was obtained from the NHS Health Research Authority and Health and Care Research Wales.
Semi-structured qualitative interviews were based on a topic guide devised and piloted by the research team. Interviews were conducted via video call, audio recorded, transcribed and anonymised. Analysis by two researchers using an exploratory inductive approach was managed in NVivo. Study design, methods, and emerging themes were discussed with our patient and public involvement (PPI) members to ensure inclusion of issues relevant to patients
Abstract - The Findings
Interviews were held with 11 GPs, 10 primary care nurses, two HF specialist nurses and one urgent care practitioner. Four themes emerged: (i) prominence of PA in discussions with PWHF is affected by practitioners’ perception of patient interest/ability, and heart failure’s low/obscured profile; (ii) scope for discussion of PA with PWHF is advanced by practitioner interest and experience and limited by practitioner uncertainty and organisational constraints, as well as patient anxiety and co-morbidity; (iii) ambiguity about community exercise resources, their use and suitability, impacts the prospect of practitioner referral; (iv) practitioners’ suggestions for practice/protocol improvements, which include a clearer focus on exercise in patient reviews and greater provision of PA information for PWHF at diagnosis.
Abstract - The Implications
Practitioners would welcome education/training to enhance their knowledge and confidence in discussing PA with PWHF.
Funding acknowledgement
We gratefully acknowledge funding from the NIHR School for Primary Care Research (SPCR)
Presentation Conference Type
Presentation / Talk
Conference Name
Society for Academic Primary Care, 53rd Annual Scientific Meeting,
