An international modified Delphi consensus study on the optimal diagnosis and treatment of patients with HFpEF

Objective: The global burden of HFpEF is high and, despite developments in available therapies, patient outcomes have not improved significantly. This study aimed to explore the optimal approaches to the diagnosis and treatment of patients with HFpEF and to develop recommendations on how guideline directed medical therapy can be introduced in a more equitable and universal manner. Methods: Using a modified Delphi methodology led by an independent facilitator, a steering group of healthcare practitioners with experience of managing HFpEF identified 41 Likert scale statements across five main domains of focus. This generated an online survey distributed by a third-party provider using a convenience sampling approach to HCPs with experience managing patients with HFpEF. Results: A total of 213 responses were analyzed with 35/41 statements attaining very strong (≥90%) agreement, 4/41 strong (≥75%) agreement, and 2/41 failing to meet the threshold established for consensus (75%). From these results, a total of 8 recommendations to define the optimal approach to diagnosis and treatment of patients with HFpEF are proposed. Conclusion: The burden of HFpEF is set to increase in the future. The high levels of consensus achieved in this study show that there is willingness to implement change and improve patient outcomes for those with this condition. A series of actionable recommendations have been developed based on the levels of agreement attained. It is hoped that the putting the current recommendations into practice will support international efforts to improve HFpEF care.