A new study has found that the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) program, led by the University of Exeter and the Royal Cornwall Hospitals NHS trust, significantly improved quality of life and is deliverable within NHS cost guidelines.

The program was co-designed by clinicians, academics, patients, and caregivers to help increase participation in rehabilitation therapies for heart failure. The five-year study received £ 2million in grant funding from the National Institute for Health Research (NIHR) under its Program Grants for Applied Research program with contributions from a number of clinical and academic partners from across the UK including Exeter, Gwent, Birmingham, York, and Dundee.

The study was published in the European Journal of Preventive Cardiology.

Approximately 900,000 people are affected by heart failure in the UK, costing the NHS £ 1bn per year. Although NICE  recommends that all people with heart failure should receive rehabilitation, less than one in 10 do.

Rehabilitation program

With this in mind, the new 2018 heart failure guidelines from NICE that patients are offered the option of a personalized home-based rehab program that is easily accessible. The rehabilitation program includes a chair-based exercise that can be easily done at home and a manual with advice on lifestyle and medication.

There is another manual for use by caregivers aimed at increasing their understanding of heart failure and aspects such as relaxation techniques, helping people come to terms with both the physical and psychological impact of heart failure.

In the study, patients who underwent the treatment for 12 months, and found that their quality of life as compared with patients undergoing rehabilitation. The cost of the intervention was £ 418 per patient (within the current price of the NHS pays for rehabilitation: £ 477).

Quality of life

Although previous hospital-based studies have shown an improvement in the quality of life and reduction in hospital admissions for patients receiving cardiac rehabilitation, heart failure finds it difficult to attend rehabilitation centers in hospitals. 

This tends to be due to a lack of access to transport, poor mobility, and other health problems and can lead to isolation and depression quality of life and reduction in hospital admissions for patients receiving cardiac rehabilitation, heart failure finds it difficult to attend rehabilitation centers in hospitals. 

The REACH-HF program is a home-based program of exercise and well-being for patients with heart failure and their caregivers which was designed to make rehabilitation more accessible. It builds on the existing Heart Manual (NHS Lothian), used with patients after a heart attack or surgery.

The study shows significant clinical benefit for patients when compared with patients not undergoing rehabilitationREACH-HF is targeted at patients with heart failure with reduced ejection fraction, where their heart muscles do not contract as effectively as they should, resulting in poorer blood circulation around the body.

Ejection Fraction

Is targeted in patients with heart failure with reduced ejection fraction, where their heart muscles do not contract as effectively as they should, resulting in poorer blood circulation around the body. This approximately half of heart failure patients.

In this study, they demonstrate the effectiveness of the REACH-HF program on the quality of life, and the ability of patients to better manage their condition. The study we demonstrate the effectiveness of the REACH-HF program on the quality of life, and the ability of patients to better manage their condition.

The results of this study provide compelling evidence that a home-based program of exercise and self-care support for people with heart failure and their caregivers should now be rolled out as part of the national NHS policy.