Exploring Facilitators and Barriers of Medically Tailored Meal Interventions for Patients Hospitalized With Acute Heart Failure: A Qualitative Study.

IF 5 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Journal of the American Heart Association Pub Date : 2025-06-17 Epub Date: 2025-06-16 DOI:10.1161/JAHA.124.038438
Ihab Hassanieh, Sang Gune K Yoo, Jing Li, Virginia McKay, Mark D Huffman
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引用次数: 0

Abstract

Background: Acute heart failure (AHF) is associated with high rehospitalization, morbidity, and mortality rates. Implementing medically tailored meal (MTM) interventions may help to optimize nutrition and improve outcomes for patients with AHF. This study aimed to explore facilitators and barriers to implementing an MTM intervention in a tertiary hospital.

Methods: From August 2023 to October 2023, we conducted semistructured interviews with health care workers and patients with AHF at Barnes Jewish Hospital in Saint Louis, Missouri. The study used the updated Consolidated Framework for Implementation Research 2.0 to assess 5 domains: MTM characteristics, inner and outer settings, individual characteristics, and implementation process. Audio files were transcribed, and data were analyzed using inductive and deductive approaches.

Results: The sample (n=30) consisted of health care workers, including cardiologists (n=5), hospitalists (n=3), nurse practitioners (n=3) and dietitians (n=4), and patients hospitalized for AHF (n=15). Participants identified facilitators including perceived trust in MTM recommendations from providers, potential for improved health outcomes, necessity for dietary compliance, and availability of multidisciplinary teams for implementation. Barriers included the need for further research on MTM efficacy, logistical complexities of MTM implementation, implementation costs, limited funding, and lack of electronic medical record integration. Patient participants had limited knowledge about MTM interventions and highlighted the importance in choosing their prescribed meal options.

Conclusions: This study identified facilitators and barriers to implementing an MTM intervention for patients with AHF in a tertiary hospital. Addressing these barriers with contextually relevant strategies could enhance the successful implementation of MTM programs.

一项质性研究:探讨急性心力衰竭住院患者医学定制膳食干预的促进因素和障碍。
背景:急性心力衰竭(AHF)与高再住院率、发病率和死亡率相关。实施医学定制膳食(MTM)干预可能有助于优化AHF患者的营养和改善预后。本研究旨在探讨在三级医院实施MTM干预的促进因素和障碍。方法:2023年8月至2023年10月,我们对密苏里州圣路易斯市巴恩斯犹太医院的医护人员和AHF患者进行了半结构化访谈。本研究使用更新的实施研究统一框架2.0来评估5个领域:MTM特征、内部和外部设置、个体特征和实施过程。对音频文件进行转录,并使用归纳和演绎方法对数据进行分析。结果:样本(n=30)包括卫生保健工作者,包括心脏病专家(n=5)、住院医生(n=3)、执业护士(n=3)和营养师(n=4),以及因AHF住院的患者(n=15)。与会者确定了促进因素,包括提供者对MTM建议的信任、改善健康结果的潜力、遵守饮食的必要性以及实施的多学科团队的可用性。障碍包括需要进一步研究MTM的有效性、MTM实施的后勤复杂性、实施成本、资金有限以及缺乏电子病历集成。患者参与者对MTM干预的了解有限,并强调了选择处方膳食选择的重要性。结论:本研究确定了三级医院对AHF患者实施MTM干预的促进因素和障碍。通过与环境相关的战略解决这些障碍可以提高MTM计划的成功实施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of the American Heart Association
Journal of the American Heart Association CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
9.40
自引率
1.90%
发文量
1749
审稿时长
12 weeks
期刊介绍: As an Open Access journal, JAHA - Journal of the American Heart Association is rapidly and freely available, accelerating the translation of strong science into effective practice. JAHA is an authoritative, peer-reviewed Open Access journal focusing on cardiovascular and cerebrovascular disease. JAHA provides a global forum for basic and clinical research and timely reviews on cardiovascular disease and stroke. As an Open Access journal, its content is free on publication to read, download, and share, accelerating the translation of strong science into effective practice.
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