Emma Burrell

Background Heart failure with preserved ejection fraction (HFpEF) causes functional limitation, poor health-related quality of life (HRQoL) and impairs prognosis.Aim Assess the clinical and cost-effectiveness of a 12-week health professional-facilitated, home-based rehabilitation intervention (REACH-HF), in people with HFpEF.Methods REACH-HFpEF is a parallel two group trial with 1:1 random allocation to the REACH-HF intervention plus usual care (intervention group) or usual care alone (control group) recruited from UK NHS centres. Outcomes are assessed at baseline and 4 and 12-month follow-up. The primary outcome measure is disease-specific HRQoL (Minnesota Living with Heart Failure questionnaire) at 12 months. Secondary outcomes: exercise capacity, psychological well-being, physical activity, generic HRQoL, frailty, blood biomarkers, mortality, hospitalisations, and serious adverse events. A process evaluation captures healthcare practitioner’s experiences and fidelity of delivery of REACH-HF. A cost-effectiveness analysis will be estimated as incremental cost per quality-adjusted life year at 12 months.Results Across 20 UK NHS sites, the REACH-HFpEF completed recruitment at end of May 2025, reaching its target sample size of 372 people with HFpEF. Participants (53% female, mean age: 78.4±7 years, BMI: 30.1±6.1 kg/m2) had a mean ejection fraction of 55.4% (±5.9) with 65% of New York Heart Association (NYHA) class II and 35% class III. Participants had of a number of comorbidities and evidence at their baseline assessment of relatively low levels of HRQoL and functional capacity and a high level of frailty.Conclusion REACH-HFpEF is the largest global trial to date of exercise-based rehabilitation in people with HFpEF and will complete last patient last follow up at the end of May 2026. This presentation will provide an overview of the trial design, an update on the trial progress, and discuss how participants’ baseline characteristics and outcomes relate to current UK practice.