Abstract P152: A Personalised Home-Based Physical Activity Intervention for Chronic Heart Failure: Do Physiological Changes Correspond with Patient Experiences?

Abstract

Background: Referrals to physical activity and exercise programmes for patients with heart failure is suboptimal with high dropout rates in hospital-based programmes. Home-based programmes have gained popularity and help address this issue. The aim of the present study was to explore patients’ experiences of participating in a personalised homebased physical activity intervention programme and to explore whether experiences corresponded with physiological changes post intervention. Methods: Twenty patients (68±7 years) with chronic heart failure (13±11 years) due to reduced ejection fraction underwent a 12-week personalised home-based physical activity programme. This involved increasing daily pedometer step count by 2000 steps from baseline. Patients completed exercise, cardiac function and quality of life tests pre-post intervention. Sixteen of the 20 patients attended one of three focus group discussions to provide their views around the decision to participate in the programme and their experience of the programme when enrolled. Results: Seventeen patients (85%) completed the intervention, and 15 patients achieved the daily target step count which increased from baseline to 3 weeks by 2546 (5108±3064 to 7654±3849, p=0.03), and maintained until week 12 (9022±3942). On completion of the intervention, quality of life improved by 15% (26±18 vs. 22±19), cardiac index and stroke volume increased by 11% and 19% respectively (6.8±1.5 vs. 7.6±2.0 L/min/m2; and 127 ± 34 vs 151 ± 34, P=0.05). Workload and O2 consumption at anaerobic threshold increased by 16% (49±16 vs. 59±14 watts, p=0.01) and 10% (11.5±2.9 vs 12.8±2.2 ml/kg/min). Thematic analyses identified 10 themes influencing participation and maintenance. These included patient’s fear of engaging in physical activity, family influences on engagement with physical activity, support from clinicians and research staff, and increased confidence as a result of participating in a personalised programme. Conclusion: A personalised home-based physical activity intervention programme is feasible and for patients with stable chronic heart failure and led to improved quality of life and submaximal exercise capacity. However, qualitative findings suggest that outcomes are likely to be contingent on personalised feedback and support from suitably trained team members to increase confidence and self-efficacy, family support, and endorsement of the programme from a clinician.