TY - JOUR
T1 - The effects and costs of home-based rehabilitation for heart failure with reduced ejection fraction
T2 - The REACH-HF multicentre randomized controlled trial
AU - Dalal, Hasnain M
AU - Taylor, Rod S.
AU - Jolly, Kate
AU - Davis, Russell C
AU - Doherty, Patrick Joseph
AU - Miles, Jackie
AU - Van Lingen, Robin
AU - Warren, Fiona C
AU - Green, Colin
AU - Wingham, Jennifer
AU - Greaves, Colin J
AU - Sadler, Susannah
AU - Hillsdon, Melvyn
AU - Abraham, Charles
AU - Britten, Nicky
AU - Frost, Julia
AU - Singh, Sally
AU - Hayward, Christopher
AU - Eyre, Victoria
AU - Paul, Kevin
AU - Lang, Chim C
AU - Smith, Karen
N1 - ©The European Society of Cardiology 2018
PY - 2019/2/1
Y1 - 2019/2/1
N2 - Background
Cardiac rehabilitation improves health-related quality of life (HRQoL) and reduces hospitalizations in patients with heart failure, but international uptake of cardiac rehabilitation for heart failure remains low.
Design and methods
The aim of this multicentre randomized trial was to compare the REACH-HF (Rehabilitation EnAblement in CHronicHeart Failure) intervention, a facilitated self-care and home-based cardiac rehabilitation programme to usual care for adults with heart failure with reduced ejection fraction (HFrEF). The study primary hypothesis was that the addition of the REACH-HF intervention to usual care would improve disease-specific HRQoL (Minnesota Living with Heart Failure questionnaire (MLHFQ)) at 12 months compared with usual care alone.
Results
The study recruited 216 participants, predominantly men (78%), with an average age of 70 years and mean left ventricular ejection fraction of 34%. Overall, 185 (86%) participants provided data for the primary outcome. At 12 months, there was a significant and clinically meaningful between-group difference in the MLHFQ score of –5.7 points (95% confidence interval –10.6 to –0.7) in favour of the REACH-HF intervention group (p = 0.025). With the exception of patient self-care (p < 0.001) there was no significant difference in other secondary outcomes, including clinical events (p > 0.05) at follow-up compared with usual care. The mean cost of the REACH-HF intervention was £418 per participant.
Conclusions
The novel REACH-HF home-based facilitated intervention for HFrEF was clinically superior in disease-specific HRQoL at 12 months and offers an affordable alternative to traditional centre-based programmes to address current low cardiac rehabilitation uptake rates for heart failure.
AB - Background
Cardiac rehabilitation improves health-related quality of life (HRQoL) and reduces hospitalizations in patients with heart failure, but international uptake of cardiac rehabilitation for heart failure remains low.
Design and methods
The aim of this multicentre randomized trial was to compare the REACH-HF (Rehabilitation EnAblement in CHronicHeart Failure) intervention, a facilitated self-care and home-based cardiac rehabilitation programme to usual care for adults with heart failure with reduced ejection fraction (HFrEF). The study primary hypothesis was that the addition of the REACH-HF intervention to usual care would improve disease-specific HRQoL (Minnesota Living with Heart Failure questionnaire (MLHFQ)) at 12 months compared with usual care alone.
Results
The study recruited 216 participants, predominantly men (78%), with an average age of 70 years and mean left ventricular ejection fraction of 34%. Overall, 185 (86%) participants provided data for the primary outcome. At 12 months, there was a significant and clinically meaningful between-group difference in the MLHFQ score of –5.7 points (95% confidence interval –10.6 to –0.7) in favour of the REACH-HF intervention group (p = 0.025). With the exception of patient self-care (p < 0.001) there was no significant difference in other secondary outcomes, including clinical events (p > 0.05) at follow-up compared with usual care. The mean cost of the REACH-HF intervention was £418 per participant.
Conclusions
The novel REACH-HF home-based facilitated intervention for HFrEF was clinically superior in disease-specific HRQoL at 12 months and offers an affordable alternative to traditional centre-based programmes to address current low cardiac rehabilitation uptake rates for heart failure.
KW - Cardiac rehabilitation
KW - health-related quality of life
KW - heart failure
KW - home-based
KW - randomized controlled trial
KW - self-management
UR - http://www.scopus.com/inward/record.url?scp=85060054938&partnerID=8YFLogxK
U2 - 10.1177/2047487318806358
DO - 10.1177/2047487318806358
M3 - Article
C2 - 30304644
VL - 26
SP - 262
EP - 272
JO - European journal of preventive cardiology
JF - European journal of preventive cardiology
SN - 2047-4873
IS - 3
ER -
