Patient and Clinician Perspectives on a Multicomponent Frailty Intervention for Adults With Heart Failure: A Qualitative Study

Introduction Heart failure (HF) is a complex clinical syndrome associated with high morbidity and mortality. Frailty is present in approximately 50% of adults living with HF and is a predictor of poor outcomes, yet few evidence-based interventions exist. Purpose To explore the perspectives of both adults living with heart failure and clinicians with HF and/or frailty expertise on developing multicomponent interventions to improve frailty in adults with HF. Methods A qualitative descriptive study was conducted with a purposive sample of 9 clinicians and 11 people living with HF. Data were collected through focus group discussions via video conference (January – November 2024). The verbatim transcripts were analysed using thematic analysis. Results Four themes were identified: 1) Perception, practice and impacts of frailty, 2) Exercise personalisation and practicality, 3) Nutritional optimisation and treatment, and 4) Psychosocial support and social engagement. Both patients and clinicians emphasised the importance of a purposeful, structured, safe, and personalised exercise programme for maximum health benefits. Clinicians recommended protein prescriptions, cardioprotective diets and suggested better integration of dietitians in routine HF clinical care. Patients emphasised the importance of psychosocial and social engagement for improving their mental and physical health and overall well-being. Both patients and clinicians suggested flexible, digital, and personalised follow-up models during the frailty intervention programme. Conclusion The insights provided on developing frailty interventions from both patient and clinician perspectives have highlighted elements of multicomponent interventions. Future interventional research should incorporate tailored exercise programs, nutritional support, and psychosocial engagement to better address the growing challenge of frailty in people living with heart failure.