Heart Failure Readmission Risk Factors: A Modified Delphi Panel Study.

Background: Heart failure (HF) readmission rates have been a significant concern for healthcare systems globally. Accurate predictive models are essential to identify patients at high readmission risk and implement timely interventions. Current models often lack comprehensive variables that reflect both clinical and patient and/or caregiver perspectives. We aimed to develop a consensus-driven approach to identify essential variables for inclusion in HF hospital readmission risk prediction algorithms. Methods: A Delphi panel comprised of clinicians and patient and/or caregiver partners was assembled. The Delphi panelists were recruited from the province of Alberta, Canada. The panel consisted of 13 individuals, including 9 healthcare providers and 4 patients and/or caregivers. The review panel was provided with a list of variables from a previously completed systematic literature review. Three rounds were conducted. The panel also determined the directionality of the association. Results: A total of 99 variables were identified through literature and physician input. Panelists reached a consensus on 61 variables, which were deemed to be associated with the risk of readmission for any cause within 30 days of discharge after HF hospitalization. Clinician ratings on consensus were consistently higher than those of nonclinicians. Conclusions: This study successfully identified 61 variables associated with HF readmission risk through a modified Delphi process, incorporating both clinician and patient and/or caregiver perspectives. These findings provide a foundation for future research and the development of more comprehensive and accurate risk prediction models. Including diverse stakeholder input highlights the importance of integrating medical expertise and patient experiences in improving HF management and reducing readmission rates.