This programme consisted of four conceptually linked work packages building on existing evidence for self-managing heart failure.
Work Package 1
This work package used systematic intervention development methods to develop a home based self-help manual for people with systolic heart failure and their caregivers (‘the HF Manual’). It was divided into two sections:
Work Package 1A – Led by Dr Colin Greaves
Research Question: What are the necessary intervention components of a home-based, self-help
manual for people with HF?
Work Package 1B – Led by Dr Jennifer Wingham
Research Question: What are the necessary intervention components of a home-based, self-help manual for the caregivers of people with HF?
This work package used qualitative research methods. The study was informed by thematic analysis involving 26 caregivers in individual interviews or a focus group. Read the full study here.
Feasibility Study
Work Package 1 includes a feasibility study to assess the feasibility and acceptability of the REACH-HF Manual for patients, caregivers and facilitators.
Work Package 2 – Led by Professor Chim Lang, Dr Karen Smith and Professor Kate Jolly
Research Question: How feasible is the HF-manual in people with heart failure?
This work package will conduct a pilot trial to assess the feasibility of a definitive trial of the heart failure manual in people who have a type of heart failure called heart failure with preserved ejection fraction (HFPEF). Read the rationale for Work Package 2 here.
Work Package 3 – Led by Professor Rod Taylor
Research Questions: What is the effectiveness and cost effectiveness of the HF manual vs. usual care in people with systolic HF? What is the impact for caregivers of using the HF Manual vs. usual care?
This work package conducted a randomised controlled trial to assess the effectiveness and cost effectiveness of HF Manual vs. usual care. 216 people with systolic HF were recruited from four centres (Abergavenny/South Wales, Birmingham, Cornwall and York). Prior to the main trial, a 6 month pilot phase checked trial feasibility and intervention acceptability. Main trial outcome measures were collected at baseline and 6 and 12 months after randomisation. A process evaluation included assessing trial fidelity; evaluating patient and caregiver experience of using the manual and measurement of caregiver stress.
The results are being analysed now and expected in 2018. Read the rationale for Work Package 2 here.
Work Package 4 Led by Professor Colin Green
Research Questions: What is the effectiveness and cost effectiveness of the HF Manual vs. centre based CR in people with systolic HF? What is the expected value of information for future research, including a randomised controlled trial of the HF manual vs. centre-based CR in people with systolic HF?
This work will use evidence synthesis/modelling methods to bring together the trial evidence on home and centre based cardiac rehabilitation to assess the effectiveness and cost effectiveness of the HF Manual (home based CR) vs. centre based CR.
Work Packages 3 and 4 will provide commissioners with evidence on the effectiveness and cost effectiveness of the HF Manual vs. usual care and vs. centre based CR. We believe that an evidence based home CR intervention could substantially improve the current suboptimal provision of CR in HF and thereby result in important improvements in patient and caregiver health outcomes and reductions in hospital admissions.