Personalising renal function monitoring and interventions in people living with heart failure: protocol for co-designing a care pathway in the RENAL-HF programme

Hargreaves, SC ORCID: 0000-0003-3240-8230, Armitage, CJ ORCID: 0000-0003-2365-1765, Brown, BC ORCID: 0000-0001-9975-4782, Dowding, D ORCID: 0000-0001-5672-8605, Downing, J, Goodall, M, Gummery, A, Lees, C, Sowden, E, Williams, NH ORCID: 0000-0002-8078-409X, Young, B ORCID: 0000-0001-6041-9901, Pirmohamed, M and RENAL-HF Consortium Personalising renal function monitoring and interventions in people living with heart failure: protocol for co-designing a care pathway in the RENAL-HF programme. BJGP open. ISSN 2398-3795 (Accepted)

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Abstract

Background Heart failure affects almost one million people in the UK and is increasing in prevalence. Many drugs used to treat heart failure impair renal function and can lead to hospitalisation. Adverse drug problems can be partially mitigated through regular renal monitoring and optimising of drug dose and choice to prevent deterioration of kidney function. This protocol describes part of a wider research programme: personalising renal function monitoring and interventions in people living with heart failure (RENAL-HF).

Aim The aim of RENAL-HF is to develop improved processes in primary care to manage kidney health in people living with heart failure.

Method The protocol covers gathering views of healthcare professionals, patients and carers, to co-develop a care pathway for use in primary care. Using a mixed methods approach, the work comprises six stages: 1) understanding current practice of optimising heart failure treatment while preserving renal function, 2) co-designing a care pathway including personalised renal function monitoring, thresholds for intervention and clinical guidelines, 3) decision-making to identify elements that will support the care pathway, 4) developing training materials for primary care to enable use of the care pathway, 5) testing the useability of the prototype care pathway, and 6) a feasibility and acceptability study to inform the pre-clinical development and usability of the care pathway ahead of a cluster randomised control trial.

Conclusion All stages will elicit evidence from primary care practices, practitioners, and patients with which to assess and refine the care pathway. The evidence will inform how algorithm-guided individualised treatment can be implemented to improve outcomes of patients with heart failure.

Item Type:	Article
Uncontrolled Keywords:	RENAL-HF Consortium; Heart failure; Renal function; optimising care; 4203 Health Services and Systems; 42 Health Sciences; Kidney Disease; Clinical Research; Health Services; Cardiovascular; Heart Disease; 7.1 Individual care needs; 4.1 Discovery and preclinical testing of markers and technologies; 7.3 Management and decision making; Renal and urogenital; Cardiovascular; 3 Good Health and Well Being; 4203 Health services and systems
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Public and Allied Health
Publisher:	Royal College of General Practitioners
Date of acceptance:	12 July 2025
Date of first compliant Open Access:	3 October 2025
Date Deposited:	03 Oct 2025 10:59
Last Modified:	03 Oct 2025 11:15
DOI or ID number:	10.3399/bjgpo.2025.0099
URI:	https://researchonline.ljmu.ac.uk/id/eprint/27258

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