MUlti-dimensional taiLored Telehealth Intervention for HFpEF (MULTI-HFpEF)
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PROJECT SUMMARY Heart failure with preserved ejection fraction (HFpEF) is the predominant form of HF affecting older adults. HFpEF exacts a heavy toll, characterized by significant morbidity and mortality, with substantial costs to the healthcare system. Exercise training has emerged as a promising modality, however, most intervention studies have focused on physical endurance only. Furthermore, no studies have addressed the modifiable health deficits that afflict older adults with HFpEF, such as depression, anxiety, and loneliness. Accordingly, we propose the MULti-dimensional tailored Telehealth Intervention (MULTI), a novel intervention that integrates physical rehabilitation targeting strength, balance, mobility, and endurance with health coaching that also addresses multiple additional health dimensions via its emphasis on emotional regulation and social engagement. We hypothesize that a 3-month telehealth multi-dimensional intervention will improve health related quality of life and physical function among older adults with HFpEF, and we will conduct a type 1 hybrid effectiveness-implementation study involving 366 participants, and the four study arms are physical rehabilitation only, health coaching only, physical rehabilitation and health coaching, and attention control. The dual primary endpoints are health related quality of life, assessed via the Kansas City Cardiomyopathy Questionnaire, and physical function, assessed via the Short Physical Performance Battery, at 180-days. Additionally, we will determine the effectiveness of the MULTI intervention on a key secondary outcome of a composite of all-cause mortality and total hospitalization and on additional secondary outcomes of geriatric conditions. Finally, we will evaluate implementation factors across multiple levels from multiple stakeholders concurrent to evaluating effectiveness. The expected outcome of the proposed study is foundational evidence on the benefit of a multi-dimensional intervention for older adults with HFpEF.
