The effects and costs of home-based rehabilitation for heart failure with reduced ejection fraction: The REACH-HF multicentre randomized controlled trial

Hasnain M Dalal, Rod S. Taylor, Kate Jolly, Russell C Davis, Patrick Joseph Doherty, Jackie Miles, Robin Van Lingen, Fiona C Warren, Colin Green, Jennifer Wingham, Colin J Greaves, Susannah Sadler, Melvyn Hillsdon, Charles Abraham, Nicky Britten, Julia Frost, Sally Singh, Christopher Hayward, Victoria Eyre, Kevin PaulChim C Lang, Karen Smith

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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.
Original languageEnglish
Pages (from-to)262-272
Number of pages11
JournalEuropean journal of preventive cardiology
Issue number3
Early online date10 Oct 2018
Publication statusPublished - 1 Feb 2019

Bibliographical note

©The European Society of Cardiology 2018


  • Cardiac rehabilitation
  • health-related quality of life
  • heart failure
  • home-based
  • randomized controlled trial
  • self-management

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