OBJECTIVES: As heart failure (HF) remains a leading cause of morbidity and mortality worldwide, tailoring treatment and care towards patient preferences is becoming increasingly important. This study aimed to explore patient perspectives among HF patients, both with reduced (HFrEF) and preserved ejection fraction (HFpEF), particularly focusing on their preferences regarding treatment and care.

METHODS: This qualitative study consisted of a scoping literature review, recruitment of participants through a cardiologist, semi-structured interviews with HF patients (n=14), preceded by an introductory survey, and a descriptive and qualitative thematic analysis of the interviews using the framework method.

RESULTS: In total, 14 HF patients (median age of 72 years, eight patients diagnosed with HFrEF, one with HFmrEF (mildy reduced), and seven with HFpEF) participated in the interviews. Their preferences and needs were assessed regarding information provided, treatment, and care. Participants preferred receiving strictly practical, personalized advice from their physician. In general, improving quality of life was prioritized over increased survival as an endpoint of symptom reduction. Furthermore, the included HFpEF patients seemed to express a greater need for effective treatment than HFrEF patients. Participants emphasized the importance of trust between patients and physicians. Moreover, treatment compliance was considered high by the participants and was further improved by using the home health nursing system. During the attribute grading exercise, the following seven attributes were identified as most important by HF patients: impact on independence, shortness of breath, impaired renal function, survival, fatigue, risk of hospitalization, and communication with and between physicians.

CONCLUSIONS: Preference heterogeneity between HFrEF and HFpEF patients was mainly observed in their treatment needs, which suggests the need to take a more holistic approach in treating HF. Furthermore, this study underscores patients’ need for shared decision-making between healthcare providers and HF patients where patients’ desired treatment and care outcomes are considered.