Document Type
Article
Publication Date
11-7-2023
Abstract
Background
The REHAB‐HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) randomized trial demonstrated that a 3‐month transitional, tailored, progressive, multidomain physical rehabilitation intervention improves physical function, frailty, depression, and health‐related quality of life among older adults with acute decompensated heart failure. Whether there is differential intervention efficacy by race is unknown.
Methods and Results
In this prespecified analysis, differential intervention effects by race were explored at 3 months for physical function (Short Physical Performance Battery [primary outcome], 6‐Minute Walk Distance), cognition, depression, frailty, health‐related quality of life (Kansas City Cardiomyopathy Questionnaire, EuroQoL 5‐Dimension‐5‐Level Questionnaire) and at 6 months for hospitalizations and death. Significance level for interactions was P≤0.1. Participants (N=337, 97% of trial population) self‐identified in near equal proportions as either Black (48%) or White (52%). The Short Physical Performance Battery intervention effect size was large, with values of 1.3 (95% CI, 0.4–2.1; P=0.003]) and 1.6 (95% CI, 0.8–2.4; P<0.001) in Black and White participants, respectively, and without significant interaction by race (P=0.56). Beneficial effects were also demonstrated in 6‐Minute Walk Distance, gait speed, and health‐related quality of life scores without significant interactions by race. There was an association between intervention and reduced all‐cause rehospitalizations in White participants (rate ratio, 0.73 [95% CI, 0.55–0.98]; P=0.034) that appears attenuated in Black participants (rate ratio, 1.06 [95% CI, 0.81–1.41]; P=0.66; interaction P=0.067).
Conclusions
The intervention produced similarly large improvements in physical function and health‐related quality of life in both older Black and White patients with acute decompensated heart failure. A future study powered to determine how the intervention impacts clinical events is required.
REGISTRATION
URL: https://www.clinicaltrials.gov. Identifier: NCT02196038.
Recommended Citation
Gilbert, Olivia N.; Mentz, Robert J.; Bertoni, Alain G.; Kitzman, Dalane W.; Whellan, David J.; Reeves, Gordon R.; Duncan, Pamela W.; Nelson, Michael Benjamin; Blumer, Vanessa; Chen, Haiying; Reed, Shelby D.; Upadhya, Bharathi; O'Connor, Christopher M.; and Pastva, Amy M., "Relationship of Race With Functional and Clinical Outcomes With the REHAB-HF Multidomain Physical Rehabilitation Intervention for Older Patients With Acute Heart Failure" (2023). Department of Medicine Faculty Papers. Paper 429.
https://jdc.jefferson.edu/medfp/429
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
PubMed ID
37889196
Language
English
Comments
This article is the author's final published version in the Journal of the American Heart Association, Volume 12, Issue 21, 7 November 2023, Article number e030588.
The published version is available at https://doi.org/10.1161/JAHA.123.030588. Copyright © 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.