Heart Failure, Systolic Clinical Trial
Official title:
Personalised Home-based Physical Activity Intervention in Older Adults With Heart Failure: Advancing Towards an Effective Clinical Therapy
The project focuses on heart failure (HF), a complex clinical syndrome of symptoms and signs
that suggest the efficiency of the heart as a pump is impaired. Around 950,000 people in the
UK have HF. Both the incidence and prevalence of heart failure increase steeply as a result
of an ageing population, improved survival of people with ischaemic heart disease and more
effective treatments for heart failure. Aside from the obvious individual burden HF also
accounts for 1 million inpatient bed days - 2% of all NHS inpatient bed days and 5% of all
emergency medical admissions to hospital which are projected to rise by 50% over the next 25
years. There is a pressing need to explore effective ways to manage the individual and
societal burden of HF.
Despite exercise being an effective, safe, and a recommended (class I) therapy for people
with heart failure according to clinical guidelines from the UK, EU, and USA, it is currently
out of reach for majority people with HF. This project addresses this directly by designing
and evaluating an exercise therapy that will be available to those living with HF with
potential to improve their symptoms, function and quality of life
The present project aligns with Ageing Body Theme of the Newcastle NIHR Biomedical Research
Centre. In particular the Chronic Cardiac Disease theme because it focuses on Heart Failure
and how to improve clinical care and outcomes, physical function and quality of life of those
living with heart failure. The project will develop and evaluate a novel non-pharmacological
therapeutic approach (home-based exercise programme with behavioural support) which
recognises the complexity of heart failure and the need to treat each individual patient in
an optimal way. Such therapy will be tailored for people with heart failure who are, under
current clinical care, lacking the well-recognised benefits associated with exercise therapy.
After initial evaluation, it is expected that this project will inform development of a large
definitive trial (subject to separate funding application) which findings will be translated
into clinical care to improve outcomes in people with heart failure. Results of such a trial
are expected to have a significant impact on current clinical practice and the development of
new cardiac rehabilitation guidelines for heart failure.
It is important to indicate that home-based exercise cardiac rehabilitation programmes have
been introduced in an attempt to widen access and participation as an alternative to
supervised centre-based rehabilitation in conditions other than heart failure. Home-based
exercise programmes are reported to be equally effective as centre based programmes in people
with coronary artery disease i.e. following myocardial infarction and/or revascularisation,
but remain to be designed and evaluated in those living with heart failure and this is
subject to the present investigation
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