Relationship Of Race With Outcomes Following A Novel Physical Rehabilitation Intervention In Older Patients Hospitalized For Heart Failure: Insights From REHAB-HF.

Background The Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial demonstrated that a transitional, tailored, progressive rehabilitation intervention improves physical function and health-related quality of life (HRQOL) among older adults with acute decompensated HF (ADHF). Differences in these domains are known to exist between race groups; however, whether there is a differential treatment effect of a physical rehabilitation intervention by race is unknown. Methods Using data from REHAB-HF, we determined if there were differential effects of the intervention by race. We examined baseline characteristics and 3-month outcomes in physical function (Short Physical Performance Battery [SPPB]) and HRQOL (Kansas City Cardiomyopathy Questionnaire [KCCQ]) and 6-month clinical events in White and Black participants and explored an interaction by race with the rehabilitation intervention. Results A total of 337 participants who self-identified as either Black or White (48% Black) were included in this analysis. Black participants tended to be younger; more likely to be female; and were less likely to have depression, live with a spouse or family member, and have college education, when compared with White participants. In Black compared with White participants, the intervention effect size on the primary outcome of SPPB at 3 months was 1.6 versus 1.3 (both p<0.01), and there was no significant interaction by race (interaction p=0.6). A similar pattern was seen for overall KCCQ score with effect sizes of 6.3 versus 7.6 (both p>0.5; interaction p=0.81). There was also no significant interaction by race on 6-month clinical event outcomes, including rehospitalization and death (all interactions p>0.05) (Table). Conclusion In this diverse population of older patients hospitalized for ADHF, the intervention produced large improvements in physical function and HRQOL compared with attention control, irrespective of race. The Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial demonstrated that a transitional, tailored, progressive rehabilitation intervention improves physical function and health-related quality of life (HRQOL) among older adults with acute decompensated HF (ADHF). Differences in these domains are known to exist between race groups; however, whether there is a differential treatment effect of a physical rehabilitation intervention by race is unknown. Using data from REHAB-HF, we determined if there were differential effects of the intervention by race. We examined baseline characteristics and 3-month outcomes in physical function (Short Physical Performance Battery [SPPB]) and HRQOL (Kansas City Cardiomyopathy Questionnaire [KCCQ]) and 6-month clinical events in White and Black participants and explored an interaction by race with the rehabilitation intervention. A total of 337 participants who self-identified as either Black or White (48% Black) were included in this analysis. Black participants tended to be younger; more likely to be female; and were less likely to have depression, live with a spouse or family member, and have college education, when compared with White participants. In Black compared with White participants, the intervention effect size on the primary outcome of SPPB at 3 months was 1.6 versus 1.3 (both p<0.01), and there was no significant interaction by race (interaction p=0.6). A similar pattern was seen for overall KCCQ score with effect sizes of 6.3 versus 7.6 (both p>0.5; interaction p=0.81). There was also no significant interaction by race on 6-month clinical event outcomes, including rehospitalization and death (all interactions p>0.05) (Table). In this diverse population of older patients hospitalized for ADHF, the intervention produced large improvements in physical function and HRQOL compared with attention control, irrespective of race.