TY  - JOUR
AU  - Dalal, HM
AU  - Taylor, RS
AU  - Jolly, K
AU  - Davis, RC
AU  - Doherty, P
AU  - Miles, J
AU  - van Lingen, R
AU  - Warren, FC
AU  - Green, C
AU  - Wingham, J
AU  - Greaves, C
AU  - Sadler, S
AU  - Hillsdon, M
AU  - Abraham, C
AU  - Britten, N
AU  - Frost, J
AU  - Singh, S
AU  - Hayward, C
AU  - Eyre, V
AU  - Paul, K
AU  - Lang, CC
AU  - Smith, K
Y2  - 2020/12/10
Y1  - 2019/02/01
SN  - 2047-4873
UR  - http://hdl.handle.net/11343/253611
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.
LA  - English
PB  - SAGE PUBLICATIONS LTD
T1  - The effects and costs of home-based rehabilitation for heart failure with reduced ejection fraction: The REACH-HF multicentre randomized controlled trial
DO  - 10.1177/2047487318806358
IS  - European Journal of Preventive Cardiology
VL  - 26
IS  - 3
SP  - 262-272
L1  - /bitstream/handle/11343/253611/PMC6376602.pdf?sequence=1&isAllowed=y
ER  -