New trial to improve health of people with angina

A team of researchers led by the University of Liverpool and the University of Leicester have secured £1.27 million research funding from the National Institute for Health Research Health Technology Assessment programme to improve the health of people with long-term angina.

Angina is a type of chest pain caused by reduced blood flow to the heart which can severely limit people’s day-to-day activities. Cardiac rehabilitation programmes, which promote the physical and mental health of people with heart disease by increasing their understanding of the disease and improving their physical fitness levels, are routinely recommended after heart attacks or heart surgery but not for people with stable angina who don’t need surgery.

The aim of the ACTIVATE trial (Angina Controlled Trial Investigating the Value of the ‘Activate your heart’ Therapeutic E-intervention) will be to measure the effectiveness of an online rehabilitation programme called ‘Activate Your Heart’ and assess its value for money.

The randomised controlled trial will recruit people who are being cared for by their GPs in practices in Liverpool, the wider North West region, Leicester and North Wales. Half of the participants will receive usual care, and half will be invited to use the online rehabilitation programme. This programme can be used at home and can be completed at the participant’s own pace. People usually access this programme using their computer or their mobile device and the programme provides them with a tailored plan for their own rehabilitation.

The trial will use questionnaires to measure physical limitations, the frequency and severity of chest pain, shortness of breath, quality of life, anxiety, depression, and the use of health services. It will also measure physical activity levels with a device worn continually for 7 days. These measurements will be taken at baseline, and after 6 and 12 months, and compared between the group receiving the ‘Activate Your Heart’ programme and the group receiving usual care.

Professor Nefyn Williams from the University’s Institute of Population Health is jointly leading the trial alongside Professor Sally Singh at the University of Leicester.

Professor Williams said: “This trial will allow us to test whether the benefits of cardiac rehabilitation can be rolled out to the large group of people with stable angina. We also want to see whether the online rehabilitation programme can reach groups that are missed by traditional programmes, particularly women, ethnic minorities and those from areas of socio-economic deprivation.”

Members of the  University of Liverpool research team include Dr Rui Duarte (Institute of Population Health), Dr Susanna Dodd and Ben Hardwick (Liverpool Clinical Trials Centre), and Professor Gregory Lip and Dr Deirdre Lane (Liverpool Centre for Cardiovascular Science).

Collaborators include Erica Morgan and Terence Comerford (Patient and Public Involvement), Professor Kate Jolly (University of Birmingham), Professor Ian Jones and Professor Dick Thijssen (Liverpool John Moores University), Professor Michael Fisher (Liverpool University Hospitals Foundation Trust) and Dr Bashir Matata (Liverpool Heart and Chest Hospital).