Comprehensive geriatric assessment (CGA) to sustain independence for older people living with heart failure with preserved ejection fracture (HFpEF) and frailty: The CHART Trial

Is a comprehensive assessment and holistic care, in addition to usual care, helpful to people with HFpEF and fraility to maintain or even improve everyday activities?

Frailty is very common in older age and develops as we age as our bodies start to lose their resilience. People living with frailty may experience sudden, dramatic changes in their wellbeing when they have health problems

Current NHS services are not well developed for people with multiple health problems. This is because they are designed to deal with one problem at a time. The result is that people may not receive the right sort of care they need.

Heart failure with preserved ejection fraction (HFpEF) means that people may have symptoms of heart failure, even when the heart pumps blood well. Half of older people with HFpEF also suffer from frailty, this can make doing everyday things difficult. They are more likely to need to go into the hospital or a care home.

Comprehensive Geriatric Assessments involves older people as well as their families, carers, and health care professionals, identifying and helping manage multiple health problems and preventing new ones arising. Rehabilitation is a key aspect of a CGA and helps people do what it is that is important to them.

What is this project doing?

433 people with HFpEF, all taking part in this study will get either:

• CGA, including 12 weeks of rehabilitation at home, on top of their usual care; or
• their usual care only

We will ask them about:

• everyday activities to see if the programme has helped maintain or improve what they can do after a year.

We will also collect information about:

•  quality of life
•  mood
•  the need for home care or need to go into a care home
•  any hospital care
• the cost of any health and social care they have.

We will also talk to older people with HFpEF, their carers and healthcare staff about their thoughts and experiences of CGA.

What are the aims of the project?

We will share our findings with the participants in the study, health and care professionals, patient organisations, policymakers and the research community. We will tailor ways of sharing the findings depending on the different audiences.

We hope that if all goes to plan and the programme works, it will be rolled out across the NHS.

Partners and Collaborators

Alison Bingham, University of Exeter

Lydia Emerson, University of Exeter

University of Leeds

University of Liverpool

NIHR ARC Yorkshire & Humber

NIHR ARC Greater Manchester

NIHR Research Delivery Network

If you want to get in contact, please get in touch with us at: CHARTstudy@exeter.ac.uk