February 1, 2021Programme Grants for Applied ResearchOpen Access

A facilitated home-based cardiac rehabilitation intervention for people with heart failure and their caregivers: a research programme including the REACH-HF RCT

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Why the study?

Participation rates in hospital-based cardiac rehabilitation by heart failure patients are suboptimal, prompting the need for a home-based intervention to increase uptake while maintaining clinical benefits.

Does a facilitated home-based cardiac rehabilitation intervention (REACH-HF) improve disease-specific health-related quality of life in adults with heart failure?

Population

216 HFrEF patients (main RCT) and 50 HFpEF patients (pilot RCT)

Comparison

REACH-HF home-based rehabilitation plus usual care vs usual care alone

Design

Multicentre unblinded randomised controlled trial

Follow-up

12 months

Authors

HDHasnain DalalHeart Failure & Transplant RTRod S TaylorNew School JWJennifer WinghamHeart Failure & Transplant

Discussion

Member takes

Implication

Supports adoption of facilitated home-based cardiac rehabilitation in HFrEF; extends evidence beyond center-based programs.

Structured PICO

Does a facilitated home-based cardiac rehabilitation intervention (REACH-HF) improve disease-specific health-related quality of life in adults with heart failure?

Population

Adults aged ≥ 18 years with heart failure, including a main cohort with reduced ejection fraction (LVEF < 45%, n=216) and a pilot cohort with preserved ejection fraction (LVEF ≥ 45%, n=50). The trial population was predominantly male (78%).

Intervention

REACH-HF intervention: a self-care, facilitated home-based cardiac rehabilitation manual offered to patients and caregivers at home over 12 weeks by trained health-care professionals, in addition to usual care.

Comparator

Usual care alone.

Outcome

Disease-specific health-related quality of life measured using the Minnesota Living with Heart Failure Questionnaire at 12 months.patient reported

A facilitated home-based cardiac rehabilitation program (REACH-HF) significantly improves disease-specific quality of life at 12 months in patients with heart failure with reduced ejection fraction, offering a viable alternative to hospital-based programs.

Limitations

Lack of blinding, meaning results may reflect participant expectation bias
Inability to capture consistent participant-level data on level of intervention adherence
Impact on generalisability due to demographics, as most were male (78%) and only seven people were from ethnic minorities

Cite This Study

Dalal et al. (2021) studied this question.

synapsesocial.com/papers/69d572d3d9840517963cd648 https://doi.org/10.3310/pgfar09010

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A facilitated home-based cardiac rehabilitation intervention for people with heart failure and their caregivers: a research programme including the REACH-HF RCT

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

A facilitated home-based cardiac rehabilitation intervention for people with heart failure and their caregivers: a research programme including the REACH-HF RCT

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

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