Caregiver outcomes of the REACH-HF multicenter randomized controlled trial of homebased rehabilitation for heart failure with reduced ejection fraction

Rod S Taylor, Jennifer Wingham, Julia Frost, Nicky Britten, Colin Greaves, Charles Abraham, Fiona C Warren, Kate Jolly, Jackie Miles , Kevin Paul, Patrick Joseph Doherty, Sally Singh, Russell Davies, Miriam Noonan, Hasnain M Dalal

Research output: Contribution to journalArticlepeer-review

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 (REACHHF) 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 adults with reduced ejection fraction (HFrEF) and left ventricular ejection fraction <45% within the past five years, caregivers were 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 to 16.8, p=0.016). No significant between group differences were seen in other caregiver outcomes. Qualitative interviews revealed that the intervention was associated with some perceived gains in the caregiving role. 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.
Original languageEnglish
JournalEuropean Journal of Cardiovascular Nursing
Publication statusPublished - 23 Apr 2019

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