Home-based cardiac rehabilitation for people living with heart failure the DK: REACH-HF pilot study
Abstract
Cardiac rehabilitation improves functional capacity and health-related quality of life in patients with heart failure. Despite strong guideline recommendations, participation in cardiac rehabilitation remains suboptimal internationally. One important barrier is that rehabilitation is most likely to be offered as a center and group-based programme, which may limit accessibility for some patients. The REACH-HF programme is a structured 12-week home-based cardiac rehabilitation intervention designed to increase accessibility and support self-management in patients with heart failure and has been adapted to the Danish healthcare context as the DK:REACH-HF programme. To evaluate the feasibility and explore preliminary effectiveness of implementing the Danish-adapted 12-week REACH-HF home-based cardiac rehabilitation programme in patients with heart failure. A feasibility study was conducted including seventy-one patients with heart failure. Participants received the 12-week DK:REACH-HF programme delivered by trained healthcare professionals. The primary outcome was change in disease-specific health-related quality of life measured by the Minnesota Living with Heart Failure Questionnaire (MLWHF). Seventy-one patients were included (mean age 74.9 years; 31% women). Most participants were in New York Heart Association class II–III (99%), and the median left ventricular ejection fraction was 30% (IQR 25–40). The MLWHF total score improved significantly from baseline to end of study (44.9 vs 36.4), showing a mean change of -8.14 points (95% CI - 11.82 to -4.45; p < 0.001). Significant improvements were also observed in the physical (-2.65; 95% CI -4.22 to -1.08; p = 0.001) and emotional subscale (- 1.77; 95% CI -2.86 to - 0.68; p = 0.002) The 12 weeks DK:REACH-HF programme significantly improved the primary outcome of disease-specific quality of life in a Danish heart failure population that would otherwise not have participated in cardiac rehabilitation.