PMID- 17343738
OWN - NLM
STAT- MEDLINE
DCOM- 20070411
LR  - 20240315
IS  - 1471-2261 (Electronic)
IS  - 1471-2261 (Linking)
VI  - 7
DP  - 2007 Mar 7
TI  - Home-based exercise rehabilitation in addition to specialist heart failure nurse 
      care: design, rationale and recruitment to the Birmingham Rehabilitation Uptake 
      Maximisation study for patients with congestive heart failure (BRUM-CHF): a 
      randomised controlled trial.
PG  - 9
AB  - BACKGROUND: Exercise has been shown to be beneficial for selected patients with 
      heart failure, but questions remain over its effectiveness, cost-effectiveness 
      and uptake in a real world setting. This paper describes the design, rationale 
      and recruitment for a randomised controlled trial that will explore the 
      effectiveness and uptake of a predominantly home-based exercise rehabilitation 
      programme, as well as its cost-effectiveness and patient acceptability. 
      METHODS/DESIGN: Randomised controlled trial comparing specialist heart failure 
      nurse care plus a nurse-led predominantly home-based exercise intervention 
      against specialist heart failure nurse care alone in a multiethnic city 
      population, served by two NHS Trusts and one primary care setting, in the United 
      Kingdom.169 English speaking patients with stable heart failure, defined as 
      systolic impairment (ejection fraction < or = 40%). with one or more hospital 
      admissions with clinical heart failure or New York Heart Association (NYHA) 
      II/III within previous 24-months were recruited.Main outcome measures at 1 year: 
      Minnesota Living with Heart Failure Questionnaire, incremental shuttle walk test, 
      death or admission with heart failure or myocardial infarction, health care 
      utilisation and costs. Interviews with purposive samples of patients to gain 
      qualitative information about acceptability and adherence to exercise, views 
      about their treatment, self-management of their heart failure and reasons why 
      some patients declined to participate. The records of 1639 patients managed by 
      specialist heart failure services were screened, of which 997 (61%) were 
      ineligible, due to ejection fraction>40%, current NYHA IV, no admission or NYHA 
      II or more within the previous 2 years, or serious co-morbidities preventing 
      physical activity. 642 patients were contacted: 289 (45%) declined to 
      participate, 183 (39%) had an exclusion criterion and 169 (26%) agreed to 
      randomisation. DISCUSSION: Due to safety considerations for home-exercise less 
      than half of patients treated by specialist heart failure services were eligible 
      for the study. Many patients had co-morbidities preventing exercise and others 
      had concerns about undertaking an exercise programme.
FAU - Jolly, Kate
AU  - Jolly K
AD  - Department of Public Health & Epidemiology, Public Health Building, University of 
      Birmingham, Edgbaston, Birmingham, B15 2TT, UK. c.b.jolly@bham.ac.uk
FAU - Tayor, Rod S
AU  - Tayor RS
FAU - Lip, Gregory Y H
AU  - Lip GY
FAU - Greenfield, Sheila M
AU  - Greenfield SM
FAU - Davies, Michael K
AU  - Davies MK
FAU - Davis, Russell C
AU  - Davis RC
FAU - Mant, Jonathan W
AU  - Mant JW
FAU - Singh, Sally J
AU  - Singh SJ
FAU - Ingram, Jackie T
AU  - Ingram JT
FAU - Stubley, Jane
AU  - Stubley J
FAU - Stevens, Andrew J
AU  - Stevens AJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20070307
PL  - England
TA  - BMC Cardiovasc Disord
JT  - BMC cardiovascular disorders
JID - 100968539
SB  - IM
MH  - Cost-Benefit Analysis
MH  - Exercise/physiology
MH  - *Exercise Therapy/economics
MH  - Heart Failure/*nursing/*rehabilitation
MH  - *Home Care Services, Hospital-Based/economics
MH  - Humans
MH  - Nursing Care
MH  - Outcome Assessment, Health Care
MH  - Patient Acceptance of Health Care
MH  - Patient Selection
MH  - Quality of Life
MH  - *Randomized Controlled Trials as Topic
MH  - Research Design
PMC - PMC1821338
EDAT- 2007/03/09 09:00
MHDA- 2007/04/12 09:00
PMCR- 2007/03/07
CRDT- 2007/03/09 09:00
PHST- 2006/11/29 00:00 [received]
PHST- 2007/03/07 00:00 [accepted]
PHST- 2007/03/09 09:00 [pubmed]
PHST- 2007/04/12 09:00 [medline]
PHST- 2007/03/09 09:00 [entrez]
PHST- 2007/03/07 00:00 [pmc-release]
AID - 1471-2261-7-9 [pii]
AID - 10.1186/1471-2261-7-9 [doi]
PST - epublish
SO  - BMC Cardiovasc Disord. 2007 Mar 7;7:9. doi: 10.1186/1471-2261-7-9.