Caregiver outcomes of the REACH-HF multicentre randomized controlled trial of home-based rehabilitation for heart failure with reduced ejection fraction

Wingham, J. et al. (2019) Caregiver outcomes of the REACH-HF multicentre randomized controlled trial of home-based rehabilitation for heart failure with reduced ejection fraction. European Journal of Cardiovascular Nursing, 18(7), pp. 611-620. (doi: 10.1177/1474515119850011)

Abstract

Background: Caregivers frequently provide support to people living with long-term conditions. However, there is paucity of evidence of interventions that support caregivers in their role. Rehabilitation EnAblement in Chronic Heart Failure (REACH-HF) is a novel home-based, health-professional-facilitated, self-management programme for patients with heart failure (HF) and their caregivers. Methods: Based on the random allocation of individual adult patients with reduced ejection fraction (HFrEF) and left ventricular ejection fraction <45% within the past five years, the caregiver of patients was allocated to receive the REACH-HF intervention over 12 weeks (REACH-HF group) or not (control group). Caregiver outcomes were generic health-related quality of life (EQ-5D-5L), Family Caregiver Quality of Life Scale questionnaire (FamQol), Caregiver Burden Questionnaire HF (CBQ-HF), Caregiver Contribution to Self-care of HF Index questionnaire (CC-SCHFI) and Hospital Anxiety and Depression Scale (HADS). Outcomes were compared between groups at 4, 6 and 12 months follow-up. Twenty caregivers receiving REACH-HF were purposively selected for qualitative interviews at 4 and 12 months. Results: Compared with controls (44 caregivers), the REACH-HF group (53 caregivers) had a higher mean CC-SCHFI confidence score at 12 months (57.5 vs 62.8, adjusted mean difference: 9.3, 95% confidence interval: 1.8–16.8, p = 0.016). No significant between group differences were seen in other caregiver outcomes. Qualitative interviews showed that most caregivers who received the REACH-HF intervention made positive changes to how they supported the HF patient they were caring for, and perceived that they had increased their confidence in the caregiver role over time. Conclusion: Provision of the REACH-HF intervention for caregivers of HF patients improved their confidence of self-management and was perceived for some to be helpful in supporting their caregiver role.

• Item Type: Articles
• Additional Information: This work was supported by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (grant number RP-PG-1210-12004). KJ is part funded by the NIHR Collaboration for Leadership and Health Research (CLAHRC) and Care West Midlands and NB and RST are both part-funded by the NIHR CLAHRC for the south west peninsula.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Taylor, Professor Rod
• Authors: Wingham, J., Frost, J., Britten, N., Greaves, C., Abraham, C., Warren, F. C., Jolly, K., Miles, J., Paul, K., Doherty, P. J., Singh, S., Davies, R., Noonan, M., Dalal, H., and Taylor, R. S.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: European Journal of Cardiovascular Nursing
• Publisher: SAGE
• ISSN: 1474-5151
• ISSN (Online): 1873-1953
• Published Online: 22 May 2019
• Copyright Holders: Copyright © 2019 The European Society of Cardiology
• First Published: First published in European Journal of Cardiovascular Nursing 18(7):611-620
• Publisher Policy: Reproduced under a Creative Commons licence