Caregiver outcomes of the REACH-HF multicentre randomized controlled trial of home-based rehabilitation for heart failure with reduced ejection fraction
Wingham, J; Frost, J; Britten, N; et al.Greaves, C; Abraham, C; Warren, F; Jolly, K; Miles, J; Paul, K; Doherty, P; Singh, S; Davies, R; Noonan, M; Dalal, H; Taylor, R
Date: 22 May 2019
Journal
European Journal of Cardiovascular Nursing
Publisher
SAGE Publications
Publisher DOI
Abstract
Background: Caregivers frequently provide support to people living with long-term conditions. However, there is
paucity of evidence of interventions that support caregivers in their role. Rehabilitation EnAblement in Chronic Heart
Failure (REACH-HF) is a novel home-based, health-professional-facilitated, self-management programme for ...
Background: Caregivers frequently provide support to people living with long-term conditions. However, there is
paucity of evidence of interventions that support caregivers in their role. Rehabilitation EnAblement in Chronic Heart
Failure (REACH-HF) is a novel home-based, health-professional-facilitated, self-management programme for patients
with heart failure (HF) and their caregivers.
Methods: Based on the random allocation of individual adult patients with reduced ejection fraction (HFrEF) and left
ventricular ejection fraction <45% within the past five years, the caregiver of patients was allocated to receive the
REACH-HF intervention over 12 weeks (REACH-HF group) or not (control group). Caregiver outcomes were generic
health-related quality of life (EQ-5D-5L), Family Caregiver Quality of Life Scale questionnaire (FamQol), Caregiver Burden
Questionnaire HF (CBQ-HF), Caregiver Contribution to Self-care of HF Index questionnaire (CC-SCHFI) and Hospital
Anxiety and Depression Scale (HADS). Outcomes were compared between groups at 4, 6 and 12 months follow-up.
Twenty caregivers receiving REACH-HF were purposively selected for qualitative interviews at 4 and 12 months.
Results: Compared with controls (44 caregivers), the REACH-HF group (53 caregivers) had a higher mean CC-SCHFI
confidence score at 12 months (57.5 vs 62.8, adjusted mean difference: 9.3, 95% confidence interval: 1.8–16.8, p =
0.016). No significant between group differences were seen in other caregiver outcomes. Qualitative interviews showed
that most caregivers who received the REACH-HF intervention made positive changes to how they supported the HF
patient they were caring for, and perceived that they had increased their confidence in the caregiver role over time.
Conclusion: Provision of the REACH-HF intervention for caregivers of HF patients improved their confidence of selfmanagement and was perceived for some to be helpful in supporting their caregiver role.
Institute of Health Research
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