Stakeholder Perspectives on a Heart Failure With Reduced Ejection Fraction Polypill: A Multi-Center Mixed Methods...

Area of Science:

• Cardiology
• Pharmacology
• Health Services Research

Background:

• A polypill combining all guideline-directed medical therapies for heart failure with reduced ejection fraction (HFrEF) could transform treatment.
• The acceptability, appropriateness, and feasibility of such a polypill strategy remain unestablished.

Purpose of the Study:

• To determine patient and provider priorities for designing HFrEF polypills.
• To assess the potential impact of a polypill-based strategy on heart failure care.

Main Methods:

• A convergent parallel mixed-methods study was conducted from April to December 2023.
• Physician surveys (n=214) assessed acceptability, feasibility, and appropriateness of HFrEF polypills.
• In-depth interviews with patients (n=9) and providers (n=22) explored care, polypill design, and support strategies.

Main Results:

• Physicians rated HFrEF polypills as highly acceptable (4.2/5), appropriate (4.1/5), and feasible (4.1/5).
• Key themes included determinants of HFrEF care, provider preferences for polypill design, cost and equity issues, and research priorities.
• Patient and provider interviews highlighted the need for titratability and consideration of health equity.

Conclusions:

• A polypill-based strategy for HFrEF is perceived as highly acceptable, appropriate, and feasible.
• Identified priorities in polypill design, titratability, and health equity will inform future clinical trials and implementation strategies.