Abstract / Summary
ABSTRACT Introduction The prevalence of chronic heart failure is increasing in Singapore and is associated with frequent hospitalisations, high costs, and impaired quality of life. Patient empowerment interventions for chronic diseases, which are structured approaches that enable patients to actively engage in and influence their care, have demonstrated promising effects on health-related outcomes. In chronic heart failure, however, many interventions focus on selected aspects of empowerment, and there remains limited synthesis of which approaches are most acceptable, preferred, and effective as comprehensive intervention packages. This protocol describes the methods for a study to identify an empowerment-based intervention for adults with chronic heart failure that is both contextually suitable and cost-effective in Singapore. Methods and analysis We will use a staged, sequential design comprising three objectives. Objective one is to conduct a systematic review and meta-analysis to synthesise international evidence of the effectiveness of empowerment-based interventions for adults with chronic heart failure. Objective two is to complete a mixed-methods study. Semi-structured interviews with patients and their caregivers, analysed using codebook thematic analysis, will identify empowerment-related needs, barriers and facilitators in local chronic heart failure care. Findings from the review and interviews will then inform a discrete choice experiment to elicit patients' preferences for features of an empowerment-based intervention, analysed using multinomial logit and latent class models. Objective three is to conduct a cost-effectiveness analysis of the selected intervention compared with usual care, using a decision tree and Markov model from the perspective of the Singapore health system. Ethics and dissemination Ethics approval for the qualitative study has been obtained from the SingHealth Centralised Institutional Review Board (ECOS Ref: 2025-1152); ethics approval for the DCE will be sought prior to recruitment. Findings will be disseminated through peer-reviewed publications and conference presentations. Registration details PROSPERO registration number: CRD420251249957; http://www.crd.york.ac.uk/PROSPERO