A home-based rehabilitation programme that could help thousands of heart failure patients to achieve a better quality of life has been shortlisted for a prestigious BMJ award.
Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) is a 12-week cardiac rehabilitation and self-management programme developed by a team led by Professor Colin Greaves of the University of Birmingham’s School of Sport, Exercise and Rehabilitation Science. The programme was co-designed by clinicians, academics, patients and caregivers.
The REACH-HF research programme was led by the Royal Cornwall Hospitals NHS Trust and the University of Exeter with funding from the National Institute for Health Research (NIHR) and contributions from clinical and academic partners across the UK including Exeter, Gwent, Birmingham, York, and Dundee.
Cardiac rehabilitation is recommended for people with heart failure. The National Heart Failure audit in 2019 showed, however, that less than one in ten participated in any programme which is well short of new targets set as part of the NHS England Long Term Plan.
Through the REACH-HF programme, cardiac nurses visit patients (and any caregivers present) in their homes to introduce the programme and then provide telephone support. The intervention includes discussion of self-care activities including symptom management, chair-based exercises, a walking plan and relaxation exercises. Patients are given an interactive booklet designed to facilitate learning from experience by recording symptoms and self-care activities and a support manual.
A randomised controlled trial showed that the intervention produced significant improvements in health-related quality of life. The mean cost for delivering the REACH-HF intervention was £418 per patient making it cost-effective. Following the success of the trial, the programme is currently being rolled out and evaluated as part of routine clinical practice in eight NHS cardiac rehabilitation centres in England, Scotland and Northern Ireland.
Professor Greaves says: “Home-based rehabilitation could help thousands of heart failure patients achieve a better quality of life. Our research gives us hope that this more accessible rehabilitation intervention will increase participation and improve patients’ quality of life.
“We now hope to see REACH-HF rolled out across the UK as a genuine menu option for cardiac rehab which will help improve uptake to rehabilitation and improve the quality of life of people with HF and their caregivers.”
Professor Kate Jolly, from the University of Birmingham’s School of Medical and Dental Sciences, led the Birmingham arm of the evaluation of the research programme.
She says: “Our evidence shows this intervention improves quality of life and is cost-effective. We’re delighted to see healthcare providers taking notice and starting to offer home-based cardiac rehabilitation programmes that will improve access to rehabilitation as well as improving participation.”
REACH-HF has been shortlisted in The BMJ Awards’ Stroke and Cardiovascular Team category. The winners will be announced on The BMJ Awards ceremony on Wednesday 22 April 2020.