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

Research output: Contribution to journalArticle


  • Jennifer Wingham
  • Julia Frost
  • Nicky Britten
  • Charles Abraham
  • Fiona C Warren
  • Jackie Miles
  • Kevin Paul
  • Patrick J Doherty
  • Sally Singh
  • Russell Davies
  • Miriam Noonan
  • Hasnain Dalal
  • Rod S Taylor

External organisations

  • 1 Primary Care Research Group, University of Exeter Medical School, UK.
  • University of Exeter
  • 3 Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, 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.


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.


Original languageEnglish
Pages (from-to)611-620
Number of pages10
JournalEuropean Journal of Cardiovascular Nursing
Issue number7
Early online date22 May 2019
Publication statusPublished - 1 Oct 2019


  • Heart failure, cardiac rehabilitation self-management, caregiver, home-based programme