Effects of the HEART Camp Trial on Adherence to Exercise in Patients With Heart Failure

Abstract

Background: Few exercise training studies in patients with heart failure (HF) report adherence to guideline-recommended 150 minutes of moderate-intensity exercise per week, and no studies have focused on a primary outcome of adherence.

Methods and results: This randomized controlled trial evaluated the effect of a multicomponent intervention, Heart Failure Exercise and Resistance Training (HEART) Camp, on adherence to exercise (after 6, 12, and 18 months) compared with an enhanced usual care (EUC) group. Patients (n = 204) were 55.4% male, overall average age was 60.4 years, and 47.5% were nonwhite. The HEART Camp group had significantly greater adherence at 12 (42%) and 18 (35%) months compared with the EUC group (28% and 19%, respectively). No significant difference (P > .05) was found at 6 months. The treatment effect did not differ based on patient's age, race, gender, marital status, type of HF (preserved or reduced ejection fraction) or New York Heart Association functional class. Left ventricular ejection fraction (LVEF) significantly moderated the treatment effect, with greater adherence at higher LVEF.

Conclusions: The multicomponent HEART Camp intervention showed efficacy with significant effects at 12 months and 18 months. Adherence levels remained modest, indicating a need for additional research to address methods and strategies to promote adherence to exercise in patients with HF.

Keywords: Exercise; adherence; exercise training; heart failure.

Copyright © 2018 Elsevier Inc. All rights reserved.

Figures

Figure 1.

CONSORT Diagram

Figure 2.

Adherence to exercise by group over time (all available data)

Figure 3.

Moderator Analysis of LVEF Note: A median split was performed in order to create an interaction plot for the significant interaction LVEF (Left ventricular ejection fraction)