{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:22:54Z","timestamp":1792794174667,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"REACH-HF"},{"name":"UK National Institute Health Research","award":["RP-PG-1210-12004"],"award-info":[{"award-number":["RP-PG-1210-12004"]}]},{"name":"UK's Department of Health and Social Care","id":[{"id":"https:\/\/ror.org\/03sbpja79","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study examined whether elevated baseline depression and anxiety moderated the effects of the REACH-HF home-based cardiac rehabilitation (CR) programme on patient outcomes in individuals with heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Individual patient data from 263 patients with HF from the REACH-HF HFrEF and HFpEF trials were analysed. At baseline, 62 (24%) had elevated depression [Hospital Anxiety and Depression Scale (HADS) D &amp;gt; 7], and 86 (33%) had elevated anxiety (HADS-A &amp;gt; 7). Patients were randomized to home-based CR plus usual care or usual care alone. Outcomes at 6\u201312 months included depression and anxiety (HADS), health-related quality of life (HRQoL) [Minnesota Living with Heart Failure Questionnaire (MLHFQ), HeartQoL], and accelerometer-measured physical activity (PA). Linear regression models, adjusting for baseline values, stratification variables, and confounders, included interaction terms (baseline depression\/anxiety \u00d7intervention group) to assess moderation effects. Those with elevated depression showed greater benefits from CR effects in depressive symptoms and HRQoL, with significant interactions for HADS-D (P = 0.004), MLHFQ (P = 0.007), HeartQoL (P = 0.001). No effects were found for PA. In participants with elevated anxiety, significant interactions were observed for HADS-D (P = 0.024), HeartQoL physical (P = 0.04), inactivity (P = 0.02), and light PA (P = 0.04). No effects were found for anxiety symptoms or HRQoL measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>People with HF participating in REACH-HF with elevated depression and anxiety experienced greater improvements in their mental health and HRQoL than individuals without elevated symptoms. Diagnostic clinical interviews in future studies would allow for stronger conclusions regarding the impact of home-based CR on patients with confirmed depression or anxiety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjcn\/zvaf196","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T11:56:47Z","timestamp":1760183807000},"page":"186-192","source":"Crossref","is-referenced-by-count":4,"title":["Impact of home-based cardiac rehabilitation in people with heart failure with elevated depressive and anxiety symptoms: a secondary analysis of the REACH-HF randomized trials"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4774-9054","authenticated-orcid":false,"given":"Jeffrey","family":"Lambert","sequence":"first","affiliation":[{"name":"Department for Health, University of Bath , Bath BA2 7AY 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