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

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 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 self-management and was perceived for some to be helpful in supporting their caregiver role.

KEYWORDS:

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

PMID:
31117815
DOI:
10.1177/1474515119850011
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