At-home cardiac rehabilitation programme is a success in Scotland
REACH-HF, an award-winning cardiac rehabilitation programme which helps people living with heart failure improve their quality of life from the convenience and safety of their own homes, should be rolled out across Scotland, according to a new study.
Led by researchers at the University of Glasgow, the SCOT:REACH-HF study followed more than 100 people with heart failure in Scotland as they participated in the REACH-HF programme. Results, which are published in the European Journal of Cardiovascular Nursing, show that the programme not only helped heart failure patients improve their quality of life, but was also an affordable method of rehabilitation care within Scotland’s NHS. As a home-based programme, REACH-HF also offers an alternative for patients to participate in their rehabilitation without having to attend classes in a hospital setting, which can be inconvenient, time consuming and involve travel costs.
This real-world study, funded by Heart Research UK and conducted in collaboration with NHS Scotland clinicians, was able to demonstrate how the rehabilitation programme could benefit people with heart failure and their caregivers.
Around one million people in the UK have heart failure. Having the condition means that the heart is unable to function efficiently, causing debilitating symptoms such as fatigue, shortness of breath and a dangerous accumulation of fluid. Heart failure can have a negative impact on a person’s quality of life and often results in unplanned hospital admissions.
Currently, heart failure costs the NHS approximately £2 billion per year, largely because of unplanned hospitalisations. Cardiac rehabilitation is an effective therapy; however, only one in 20 people with a diagnosis of heart failure currently receive rehabilitation. Key barriers include people with heart failure being unable to travel to hospital to take part in classes, as well more general issues around funding and resources within the NHS.
Researchers have now shown that the roll out of REACH-HF to heart failure patients across Scotland could successfully overcome these barriers, as the cost-effective programme is designed to be followed at home.
The 12-week programme includes chair-based exercises, a walking plan, audio with relaxation techniques, and a manual with advice on lifestyle and medication.
Participants also receive an interactive booklet designed to facilitate learning from experience, by helping them to record symptoms, physical activity and other aspects of self-care. Alongside this, a ‘friends and family’ manual aims to support those who provide informal care to people with heart failure at home and improve their understanding of the condition too. The programme is fully facilitated by healthcare professionals through a mix of home visits and telephone calls.
Dr Carrie Purcell, lead author of the study from the University of Glasgow, said: “As a home-based programme that can provide remote support from healthcare professionals, we knew REACH-HF could overcome many of the obstacles that prevent people with heart failure taking part in hospital-based programmes. Through this study we have now also shown that the programme can improve the quality of life and health of people with heart failure and be delivered in a cost-effective way in the NHS in Scotland.”
The Rehabilitation Enablement in CHronic Heart Failure (REACH-HF) programme, was originally developed by a collaboration led by Professor Rod Taylor (University of Glasgow) and Dr Hasnain Dalal (University of Exeter and the Royal Cornwall Hospitals NHS Trust), and a UK-based team of researchers.
Professor Taylor, Professor of Population Health Research at the University of Glasgow, said: “Rehabilitation is key element of care to help people with heart failure live their lives as well as possible. REACH-HF can not only improve the quality of life of heart failure patients and help keep them out of hospital, it is also cost-effective in a real-world setting, and support the programme being made available by Health Boards across Scotland’s NHS.”
The study - ‘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)’ - is published in the European Journal of Cardiovascular Nursing. The study was funded by Heart Research UK.
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First published: 19 January 2023