Published 8th October 2020

A home-based rehabilitation programme that could help thousands of people with heart failure to achieve a better quality of life has won a prestigious British Medical Journal (BMJ) award. The programme, which is co-led by Professor Rod Taylor from the MRC/CSO Social and Public Health Sciences Unit, won the Stroke and Cardiovascular Team category.

Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) is a 12-week cardiac rehabilitation and self-management programme developed by a team co-led by Professor Rod Taylor, and Dr Hayes Dalal of the University of Exeter and Royal Cornwall Hospitals NHS Trust. The programme was co-designed by clinicians, academics, people with heart failure and their caregivers.

The REACH-HF research programme was supported with funding from the National Institute for Health Research (NIHR) and contributions from clinical and academic partners across the UK, including Glasgow, Exeter, Gwent, Birmingham, York, and Dundee.

Cardiac rehabilitation is recommended for people with heart failure. The National Heart Failure audit in 2019 showed, however, that less than one in ten participated in any programme, which is well short of new targets set as part of the NHS England Long Term Plan.

Through the REACH-HF programme, cardiac nurses visit people with heart failure (and any caregivers present) in their homes to introduce the programme, and then provide telephone support. The intervention includes discussion of self-care activities including symptom management, chair-based exercises, a walking plan and relaxation exercises. Programme participants are given an interactive booklet – designed to facilitate learning from experience by recording symptoms and self-care activities – and a support manual.

A randomised controlled trial showed that REACH-HF produced significant improvements in health-related quality of life. The average cost for delivering REACH-HF was £418 per patient, making it cost-effective. Following the success of the trial, the programme is currently being rolled out across four sites in Scotland, with funding from Heart Research UK. SCOT:REACH-HF is being led by Professor Taylor, Dr Carrie Purcell and Dr Tracy Ibbotson also of the University of Glasgow.

Professor Taylor says: “In spite of good evidence, sadly only 1 in 20 people with heart failure currently receive rehabilitation. REACH-HF is an evidence-based home rehabilitation programme that can help thousands of heart failure patients access rehabilitation with huge benefits to these individuals, including substantive improvements in quality of life, and reduced risk of future hospital admission and death.”

“Working with the NHS, we are seeking to embed REACH-HF as standard care for people with heart failure and their families. This is especially relevant in this time of the COVID-19 pandemic when, for the safety of patients and health of staff, patients are not always able to come to hospitals or community centres to take part in rehabilitation”

First published: 8 October 2020

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