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Man taking part in cardiac rehabilitation programme

A home-based rehabilitation programme that could help thousands of heart failure patients to achieve a better quality of life has won a prestigious BMJ award.

The Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) programme was recognised in the 2020 BMJ Awards as 'Stroke and Cardiovascular Team of the Year”. The programme was developed by a collaboration led by the University of Exeter and the Royal Cornwall Hospitals NHS Trust with contributions from clinical and academic partners across the UK including Exeter, Glasgow, Gwent, Birmingham, York, Dundee and Plymouth. It was funded by the National Institute for Health Research (NIHR).

Researchers from the University of Birmingham led the development of the REACH-HF intervention – the activities and self-care to be carried out by the patient – and helped to evaluate the REACH-HF programme in a major national trial, funded by the National Institute for Health Research.

Dr Hasnain Dalal, of the Royal Cornwall Hospitals NHS Trust and the University of Exeter Medical School, says: “We’re delighted to receive the 2020 BMJ Award. We would like to thank the judging panel for recognising the dedication of our hard-working REACH-HF team in developing and evaluating a novel home-based rehabilitation programme for people with heart failure and their caregivers over the last decade.

Professor Rod Taylor of the University of Glasgow, says “Winning this prestigious award will help bring further recognition of the impact of heart failure, the importance of rehabilitation, and the urgent need for NHS commissioners and providers to improve access with programmes such as REACH-HF.  With less than 1 in 10 heart failure patients participating in rehabilitation even before the outbreak of COVID-19, we anticipate that REACH-HF will help to make a significant impact on the poor uptake”

Professor Colin Greaves of the University of Birmingham’s School of Sport, Exercise and Rehabilitation Science, says: “The REACH-HF programme is designed to address the needs and concerns of each individual patient.  It draws on a wealth of patient experience, it includes wisdom and advice from the UK’s top cardiac rehabilitation specialists and is supercharged with latest behavioural science. We are delighted to see this recognised by the BMJ judging panel – and hope the REACH-HF home based rehab programme will be a big part of the future of cardiac rehabilitation.”

Through the REACH-HF programme, cardiac nurses visit patients (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.  Patients 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, coordinated by the Peninsula Clinical Trials Unit (University of Plymouth) showed that the intervention produced significant improvements in health-related quality of life. The mean cost for delivering the REACH-HF intervention was £418 per patient making it cost-effective. Following the success of the trial, the programme is currently being rolled out and evaluated as part of routine clinical practice in eight NHS cardiac rehabilitation centres in England, Scotland and Northern Ireland.

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