![]() ![]() Almost 50% of HF patients have preserved ejection fraction (HFpEF), and its prevalence is predicted to grow. In the United Kingdom (UK), approximately one million people live with heart failure (HF)-a condition which negatively affects cardiovascular functioning, often presenting with debilitating symptoms of fatigue, shortness of breath, reduced exercise capacity, and a potentially dangerous accumulation of fluid in bodily tissues. ![]() (1) emphasis in the patient-facing documentation used for participant recruitment of the importance of co-involvement of a caregiver (such as a spouse, family member, or friend) to actively support the patient with their engagement in the intervention (2) enhance the facilitator training of healthcare professions to highlight both the challenges/opportunities of engaging caregivers and the key role that caregivers can bring as agents of sustainable patient behaviour change and (3) assess the fidelity of intervention delivery to check caregiver engagement is achieved and to explore how fidelity impacts on HFpEF patient and caregiver outcomes. Results will guide the research team in the design and delivery of a recently funded multicentre trial of REACH-HF in this population, i.e. This study highlights the need for support for HFpEF patients and their caregivers. What are the implications of the feasibility findings for the design of the main study? However, whilst the fidelity analysis found the interventions to be delivered adequately over many of its components, we also found scope for improvement-particularly in relation to caregiver engagement. Results of this process evaluation sub-study of a single-centre pilot trial showed the REACH-HF intervention was largely successfully delivered and well received by participants. Using qualitative research methods, this pilot trial process evaluation sought to address the uncertainties of (1) whether the REACH-HF intervention could be delivered with acceptable fidelity and (2) HFpEF patients’ and caregivers’ experiences of participation in the intervention Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) is a healthcare professional-facilitated home-based rehabilitation intervention designed to improve self-care and health-related quality of life in people with heart failure. Trials of clinical and cost-effective therapies in the HFpEF population are much needed. People with heart failure with preserved ejection fraction (HFpEF) have a high unmet need, experiencing low levels of health-related quality of life and an absence of evidence-based treatment options. What uncertainties existed regarding the feasibility? ISRCTN78539530 (date of registration 7 July 2015). Results of this study will inform a recently funded full multicentre randomised clinical trial. The REACH-HF home-based facilitated intervention for HFpEF appears to be a feasible and a well-accepted model for the delivery of rehabilitation, with the potential to address key unmet needs of patients and their caregivers who are often excluded from HF and current cardiac rehabilitation programmes. The differing professional backgrounds of REACH-HF facilitators in this study demonstrate the possibility of delivery of the intervention by healthcare staff with expertise in HF, cardiac rehabilitation, or both. Fidelity analysis found the interventions to be delivered adequately with scope for improvement in caregiver engagement. Qualitative information from the facilitator interactions and interviews identified three key themes for patients and caregivers: (1) understanding their condition, (2) emotional consequences of HF, and (3) responses to the REACH-HF intervention. ![]() Interviews were conducted following completion of intervention in a purposeful sample of 15 HFpEF patients and seven caregivers. The REACH-HF intervention consisted of self-help manual for patients and caregivers, facilitated over 12 weeks by trained healthcare professionals. Process evaluation sub-study parallels to a single-centre (Tayside, Scotland) randomised controlled pilot trial with qualitative assessment of both intervention fidelity delivery and HFpEF patients’ and caregivers’ experiences. This study reports the process evaluation of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention for HFpEF patients and their caregivers conducted as part of the REACH-HFpEF pilot trial. ![]() However, there is growing evidence of the potential value of exercise-based cardiac rehabilitation. Whilst almost 50% of heart failure (HF) patients have preserved ejection fraction (HFpEF), evidence-based treatment options for this patient group remain limited. ![]()
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