Purcell, C. , Purvis, A., Cleland, J. G.F. , Cowie, A., Dalal, H. M., Ibbotson, T. , Murphy, C. and Taylor, R. S. (2023) Home-based cardiac rehabilitation for people with heart failure and their caregivers: a mixed-methods analysis of the roll out an evidence-based programme in Scotland (SCOT:REACH-HF study). European Journal of Cardiovascular Nursing, 22(8), pp. 804-813. (doi: 10.1093/eurjcn/zvad004) (PMID:36617216)
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Abstract
Aims: Alternative models of cardiac rehabilitation (CR) are required to improve CR access and uptake. Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) is a comprehensive home-based rehabilitation and self-management programme, facilitated by trained health professionals, for people with heart failure (HF) and their caregivers. REACH-HF was shown to be clinically effective and cost-effective in a multicentre randomised trial. The SCOT:REACH-HF study assessed implementation of REACH-HF in routine clinical practice in NHS Scotland. Methods & results: A mixed-method implementation study was conducted across six regional Health Boards. Of 136 people with HF and 56 caregivers recruited, 101 people with HF and 26 caregivers provided four-month follow-up data, after participating in the 12-week programme. Compared with baseline, REACH-HF participation resulted in substantial gains in the primary outcome of health-related quality of life, as assessed by the Minnesota Living with Heart Failure Questionnaire (mean difference: -9.8, 95% CI: -13.2 to -6.4, P < 0.001). Improvements were also seen in secondary outcomes (PROM-CR+; EQ-5D-5L; Self-Care of Heart Failure Index (SCHFI) domains of maintenance and symptom perception; Caregiver Contribution to Self-Care (CC-SCHFI) domains of symptom perception and management). Twenty qualitative interviews were conducted with 11 REACH-HF facilitators, five supporting clinicians, and four national stakeholders. Interviewees were largely positive about REACH-HF, considering it to have ‘filled a gap’ where centre-based CR was not an option. Key issues to support future roll-out were also identified. Conclusion: Our findings support wider roll-out of REACH-HF as an alternative to centre-based models, to improve CR access and uptake for people with HF.
| Item Type: | Articles |
|---|---|
| Additional Information: | The work was funded by Heart Research UK, grant no. RG2685. The study was conducted and the manuscript completed while CP was a Research Fellow at the University of Glasgow. AP’s time was supported by the Medical Research Council (grant number MC_UU_00022/1) and Chief Scientist Office of the Scottish Government Health and Social Care Directorates (grant number SPHSU16). |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Purcell, Dr Carrie and Cleland, Professor John and Purvis, Mr Anthony and Taylor, Professor Rod and Ibbotson, Dr Tracy |
| Authors: | Purcell, C., Purvis, A., Cleland, J. G.F., Cowie, A., Dalal, H. M., Ibbotson, T., Murphy, C., and Taylor, R. S. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre |
| Journal Name: | European Journal of Cardiovascular Nursing |
| Publisher: | Oxford University Press |
| ISSN: | 1474-5151 |
| ISSN (Online): | 1873-1953 |
| Published Online: | 06 January 2023 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in European Journal of Cardiovascular Nursing 22(8):804-813 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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