Evidence map›Paper›PMID 30884975›Full record

SynthesisEuropean journal of preventive cardiology2019

The cost effectiveness of REACH-HF and home-based cardiac rehabilitation compared with the usual medical care for heart failure with reduced ejection fraction: A decision model-based analysis.

Rod S Taylor, Susannah Sadler, Hasnain M Dalal, Fiona C Warren, Kate Jolly, Russell C Davis, Patrick Doherty, Jackie Miles, Colin Greaves, Jennifer Wingham and 9 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of preventive cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Measurement properties of utility-based health-related quality of life measures in cardiac rehabilitation and secondary prevention programs: a systematic review.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024
    Pooled it
  2. Exercise-based cardiac rehabilitation for adults with heart failure.The Cochrane database of systematic reviews · 2024
    Pooled it
  3. Home-based versus centre-based cardiac rehabilitation.The Cochrane database of systematic reviews · 2023
    Pooled it
  4. Trial
  5. Trial
  6. Trial
  7. Article
  8. Article
  9. Article
  10. Article
  11. Comprehensive Self-Management of Heart Failure.Journal of cardiovascular development and disease · 2025
    Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. The Place and Value of Sodium-Glucose Cotransporter 2 Inhibitors in the Evolving Treatment Paradigm for Type 2 Diabetes Mellitus: A Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2022 · on this map
    Review
  17. Review
  18. Article
  19. Article
  20. Virtual and in-person cardiac rehabilitation.BMJ (Clinical research ed.) · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Rod S Taylor1 Institute of Health Research, University of Exeter College of Medicine and Health and Institute of Health and Wellbeing, University of Glasgow, UK.
Susannah Sadler1 Institute of Health Research, University of Exeter College of Medicine and Health and Institute of Health and Wellbeing, University of Glasgow, UK.
Hasnain M Dalal2 University of Exeter College of Medicine and Health and Royal Cornwall Hospitals NHS Trust, Truro, UK.
Fiona C Warren1 Institute of Health Research, University of Exeter College of Medicine and Health and Institute of Health and Wellbeing, University of Glasgow, UK.
Kate Jolly3 Institute of Applied Health Research, University of Birmingham, UK.
Russell C Davis4 Cardiology Department, Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK.
Patrick Doherty5 Department of Health Sciences, University of York, UK.
Jackie Miles6 Research and Development, Aneurin Bevan University Health Board, St Woolos Hospital, Newport, UK.
Colin Greaves7 Institute of Health Research, University of Exeter Medical School, UK.
Jennifer Wingham1 Institute of Health Research, University of Exeter College of Medicine and Health and Institute of Health and Wellbeing, University of Glasgow, UK.
Melvyn Hillsdon8 Sport and Health Sciences, University of Exeter, UK.
Charles Abraham7 Institute of Health Research, University of Exeter Medical School, UK.
Julia Frost1 Institute of Health Research, University of Exeter College of Medicine and Health and Institute of Health and Wellbeing, University of Glasgow, UK.
Sally Singh9 Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Glenfield Hospital, UK.
Christopher Hayward10 Peninsula Clinical Trials Unit, University of Plymouth, UK.
Victoria Eyre11 Re:Cognition Health, London, UK.
Kevin Paul12 REACH-HF Patient and Public Involvement Group, c/o Research, Development & Innovation, Royal Cornwall Hospitals NHS Trust, Truro, UK.
Chim C Lang13 School of Medicine, University of Dundee, Ninewells Hospital and Medical School, UK.
Karen Smith14 School of Nursing and Health Sciences, University of Dundee, UK.

Funding

Department of Health RP-PG-1210-12004
6 · The paper itself

Abstract

backgroundThe REACH-HF (Rehabilitation EnAblement in CHronic Heart Failure) trial found that the REACH-HF home-based cardiac rehabilitation intervention resulted in a clinically meaningful improvement in disease-specific health-related quality of life in patients with reduced ejection fraction heart failure (HFrEF). The aims of this study were to assess the long-term cost-effectiveness of the addition of REACH-HF intervention or home-based cardiac rehabilitation to usual care compared with usual care alone in patients with HFrEF. DESIGN AND

methodsA Markov model was developed using a patient lifetime horizon and integrating evidence from the REACH-HF trial, a systematic review/meta-analysis of randomised trials, estimates of mortality and hospital admission and UK costs at 2015/2016 prices. Taking a UK National Health and Personal Social Services perspective we report the incremental cost per quality-adjusted life-year (QALY) gained, assessing uncertainty using probabilistic and deterministic sensitivity analyses.

resultsIn base case analysis, the REACH-HF intervention was associated with per patient mean QALY gain of 0.23 and an increased mean cost of £400 compared with usual care, resulting in a cost per QALY gained of £1720. Probabilistic sensitivity analysis indicated a 78% probability that REACH-HF is cost effective versus usual care at a threshold of £20,000 per QALY gained. Results were similar for home-based cardiac rehabilitation versus usual care. Sensitivity analyses indicate the findings to be robust to changes in model assumptions and parameters.

conclusionsOur cost-utility analyses indicate that the addition of the REACH-HF intervention and home-based cardiac rehabilitation programmes are likely to be cost-effective treatment options versus usual care alone in patients with HFrEF.

Indexed as

Health Care CostsStroke VolumeVentricular Function, LeftAgedAged, 80 and overCardiac RehabilitationCost-Benefit AnalysisFemaleHeart FailureHome Care ServicesHumansMaleMarkov ChainsModels, EconomicQuality-Adjusted Life YearsQuality of LifeCardiac rehabilitationcost-effectivenessdecision modelhealth-related quality of lifeheart failurehome-based

Identifiers

PMID30884975
PMCPMC6628466

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.