Needs of multimorbid elderly with chronic heart failure regarding a blended- collaborative care: A qualitative interview study in preparation of an intervention within the EU project ESCAPE

Objective Blended collaborative care (BCC) can improve quality of life and well-being in patients with chronic heart failure (CHF). However, few of the studies have explicitly explored patients'and carers'health and treatment preferences before implementing BCC. To better customize the intervention, this international study aimed to investigate patients' and carers' perceived needs. Methods Based on an existing BCC intervention a multinational interview guide was developed. Interviews were conducted in Germany, Denmark and Italy with patients aged over 65 years, having CHF and at least two other physical diseases and their informal carers. Using framework analysis, prototype profiles of patients and carers were created. Results Transcripts from 21 patients and 16 carers were analyzed. Initially, 8 country-specific profiles were identified and iteratively were narrowed down to a final set of 3 international profiles: a) Those who need and want support. B) Those who actively engage in self-care and only reach out to the health care system when they need support. C) Those who feel neglected from the health care system and do not believe in professional support. Whereas carers of the first two profiles were content with Discussion To best of our knowledge, this is the first multinational qualitative study on patients' and carers' needs regarding a BCC intervention. Across countries, results revealed three contrasting profiles which will serve as a basis for the development of a BCC intervention within the EU-wide study ESCAPE.