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).
In: European Journal of Cardiovascular Nursing, Jg. 22 (2023-11-01), Heft 8, S. 804-813
academicJournal
Zugriff:
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 multi-centre randomized trial. The SCOT:REACH-HF study assessed implementation of REACH-HF in routine clinical practice in NHS Scotland. Methods and 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 4-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 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. Graphical Abstract [ABSTRACT FROM AUTHOR]
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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).
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Autor/in / Beteiligte Person: | Purcell, Carrie ; Purvis, Anthony ; Cleland, John G F ; Cowie, Aynsley ; Dalal, Hasnain M ; Ibbotson, Tracy ; Murphy, Clare ; Taylor, Rod S |
Zeitschrift: | European Journal of Cardiovascular Nursing, Jg. 22 (2023-11-01), Heft 8, S. 804-813 |
Veröffentlichung: | 2023 |
Medientyp: | academicJournal |
ISSN: | 1474-5151 (print) |
DOI: | 10.1093/eurjcn/zvad004 |
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