A pragmatic effectiveness-implementation study comparing trial evidence with routinely collected outcome data for patients receiving the REACH-HF home-based cardiac rehabilitation programme.
dc.contributor.author | Daw, P | |
dc.contributor.author | Harrison, A | |
dc.contributor.author | Doherty, PJ | |
dc.contributor.author | van Zanten, JJCSV | |
dc.contributor.author | Dalal, HM | |
dc.contributor.author | Taylor, RS | |
dc.contributor.author | van Beurden, SB | |
dc.contributor.author | McDonagh, STJ | |
dc.contributor.author | Greaves, CJ | |
dc.date.accessioned | 2022-07-13T14:01:41Z | |
dc.date.issued | 2022-06-16 | |
dc.date.updated | 2022-07-13T13:34:46Z | |
dc.description.abstract | BACKGROUND: Cardiac rehabilitation for heart failure continues to be greatly underused worldwide despite being a Class I recommendation in international clinical guidelines and uptake is low in women and patients with mental health comorbidities. METHODS: Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) programme was implemented in four UK National Health Service early adopter sites ('Beacon Sites') between June 2019 and June 2020. Implementation and patient-reported outcome data were collected across sites as part of the National Audit of Cardiac Rehabilitation. The change in key outcomes before and after the supervised period of REACH-HF intervention across the Beacon Sites was assessed and compared to those of the intervention arm of the REACH-HF multicentre trial. RESULTS: Compared to the REACH-HF multicentre trial, patients treated at the Beacon Site were more likely to be female (33.8% vs 22.9%), older (75.6 vs 70.1), had a more severe classification of heart failure (26.5% vs 17.7%), had poorer baseline health-related quality of life (MLHFQ score 36.1 vs 31.4), were more depressed (HADS score 6.4 vs 4.1) and anxious (HADS score 7.2 vs 4.7), and had lower exercise capacity (ISWT distance 190 m vs 274.7 m). There appeared to be a substantial heterogeneity in the implementation process across the four Beacon Sites as evidenced by the variation in levels of patient recruitment, operationalisation of the REACH-HF intervention and patient outcomes. Overall lower improvements in patient-reported outcomes at the Beacon Sites compared to the trial may reflect differences in the population studied (having higher morbidity at baseline) as well as the marked challenges in intervention delivery during the COVID-19 pandemic. CONCLUSION: The results of this study illustrate the challenges in consistently implementing an intervention (shown to be clinically effective and cost-effective in a multicentre trial) into real-world practice, especially in the midst of a global pandemic. Further research is needed to establish the real-world effectiveness of the REACH-HF intervention in different populations. | en_GB |
dc.description.sponsorship | University of Birmingham | en_GB |
dc.format.extent | 270- | |
dc.format.medium | Electronic | |
dc.identifier.citation | Vol. 22, article 270 | en_GB |
dc.identifier.doi | https://doi.org/10.1186/s12872-022-02707-5 | |
dc.identifier.uri | http://hdl.handle.net/10871/130255 | |
dc.identifier | ORCID: 0000-0002-7316-7544 (Dalal, Hasnain M) | |
dc.identifier | ORCID: 0000-0001-7848-2159 (van Beurden, Samantha B) | |
dc.identifier | ScopusID: 57163393500 (van Beurden, Samantha B) | |
dc.identifier | ORCID: 0000-0002-0283-3095 (McDonagh, Sinéad TJ) | |
dc.language.iso | en | en_GB |
dc.publisher | BMC | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/35710336 | en_GB |
dc.rights | © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. | en_GB |
dc.subject | Cardiac rehabilitation | en_GB |
dc.subject | Heart failure | en_GB |
dc.subject | Quality of life | en_GB |
dc.subject | Quantitative evaluation | en_GB |
dc.subject | Routinely collected health data | en_GB |
dc.subject | Treatment outcome | en_GB |
dc.title | A pragmatic effectiveness-implementation study comparing trial evidence with routinely collected outcome data for patients receiving the REACH-HF home-based cardiac rehabilitation programme. | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2022-07-13T14:01:41Z | |
dc.identifier.issn | 1471-2261 | |
exeter.article-number | 270 | |
exeter.place-of-publication | England | |
dc.description | This is the final version. Available from BMC via the DOI in this record. | en_GB |
dc.description | Availability of data and materials: The datasets analysed during the current study are available from the corresponding author on reasonable request | en_GB |
dc.identifier.journal | BMC Cardiovascular Disorders | en_GB |
dc.relation.ispartof | BMC Cardiovasc Disord, 22(1) | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2022-06-02 | |
dc.rights.license | CC BY | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2022-06-16 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2022-07-13T13:58:55Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2022-07-13T14:02:08Z | |
refterms.panel | A | en_GB |
refterms.dateFirstOnline | 2022-06-16 |
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mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.