Send to

Choose Destination
Eur J Cardiovasc Nurs. 2019 May 22:1474515119850011. doi: 10.1177/1474515119850011. [Epub ahead of print]

Caregiver outcomes of the REACH-HF multicentre randomized controlled trial of home-based rehabilitation for heart failure with reduced ejection fraction.

Author information

1 Primary Care Research Group, University of Exeter Medical School, UK.
2 Institute of Health Research, University of Exeter Medical School, UK.
3 Institute of Applied Health Research, University of Birmingham, UK.
4 Anuerin Bevan University Health Board, Research and Development, Abergavenny, UK.
5 REACH-HF Patient and Public Involvement Group, c/o Royal Cornwall Hospitals NHS Trust, UK.
6 National Audit of Cardiac Rehabilitation, University of York, UK.
7 University Hospitals of Leicester NHS Trust, UK.
8 Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK.
9 Royal Cornwall Hospitals NHS Trust, Truro, UK.
10 Institute of Health and Well Being, University of Glasgow, UK.



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.


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.


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.


Provision of the REACH-HF intervention for caregivers of HF patients improved their confidence of self-management and was perceived for some to be helpful in supporting their caregiver role.


Heart failure; cardiac rehabilitation self-management; caregiver; home-based programme

Free full text

Supplemental Content

Full text links

Icon for Atypon Icon for White Rose Research Online
Loading ...
Support Center