Participant experiences and engagement with the enhanced heart failure care program: a qualitative study

Introduction: Mental health disorders are common among people with heart failure (HF). The Enhanced HF Care program is a digital health intervention designed to remotely monitor and support the wellbeing of patients discharged with acute decompensated HF via online modules and surveys. This qualitative study explores participants' experiences, engagement with and feedback on the program. Methods: The design was a qualitative in-trial sub-study. Participants were recruited pre-discharge from two public hospitals in New South Wales, Australia. Semi-structured telephone interviews were conducted one- and/or six-months post-recruitment with a sample of participants who received the intervention to understand their experience of the program. Transcripts were analysed based on a qualitative descriptive approach and content analysis. Results: Twenty-four interviews were conducted with 18 participants (3 female, 15 male; age range 39-87 years). Four overarching themes were identified: program engagement; program benefits; additional information needs; and multidimensional perspectives on health. Most participants reported the program as beneficial, comprehensive and detailed enough for their needs, particularly valuing the opportunity for self‑reflection on mental and physical health. However, engagement was variable, with competing priorities and feeling overwhelmed after discharge limiting uptake for some participants. Easy post‑discharge access to information and the ability to share it with family were also valued. Discussion: Patient feedback highlighted the acceptability and positive impacts of the program, though some challenges remain for uptake including information overload and competing time priorities. These findings underscore the importance of timing, tailoring, and responsiveness to individual patient contexts within digital health interventions.