Site Highlight- The Queen’s Medical Center in Honolulu Hawaii

The Queen's Medical Center in Honolulu Hawaii
The Queen’s Medical Center in Honolulu Hawaii has enrolled 115 patients into CONNECT-HF as of September 2019

As part of our new Enrollment Campaign, we are planning to feature CONNECT-HF sites to learn about how the study works in their hospitals and their tips for success. This month, we feature The Queen’s Medical Center in Honolulu, Hawaii.

Queen’s is the largest private hospital in Hawaii, licensed to operate with 505 acute care beds and 28 sub-acute beds. With 3,600 employees—including 1,160 nurses and over 1,100 physicians on staff—it is also one of the state of Hawaii’s largest employers. It is a Level I trauma center and the only designated trauma center in the state of Hawaii, and first Level I in the Pacific.

As the leading medical referral center in the Pacific Basin, Queen’s is widely known for its programs in cancer, cardiovascular disease, neuroscience, orthopedics, surgery, trauma, behavioral medicine and women’s health. Queen’s joined the CONNECT-HF study in May of 2017.

The Queen’s Medical Center CONNECT HF research team describes it this way: “CONNECT-HF is an exponential win for everyone involved. The study supports the participants understanding of how changes in their self-care actions can result in positive heart failure outcomes. In addition, participants also appreciate being acknowledged in the research process and having their voice heard. The extended health care community of providers and researchers care about them and support them on their path to health.”

“We appreciate our participants and express our gratitude by letting them know we could not do research without them. CONNECT-HF allows participants and researchers to work together to answer the study questions and improve the care for all those with heart failure,” said the study team.

Providers whose patients are part of the study are happy that their (patients) are part of a study designed to improving understanding of heart failure self-care actions and outcomes. The study team says the hospital benefits from the fellowship and leadership of the national heart failure quality improvement community as well.

We thank The Queen’s Medical Center for their efforts to promote CONNECT-HF and congratulate them on enrolling 115 patients so far!

How to deal with seasonal allergies and heart conditions

Do you look forward to the warm weather and budding flowers that signal spring, or dread the pollen and other allergens to come? Dealing with allergy symptoms is never fun, but it can be additionally complicated if you have a heart condition.

Forecasts for this year indicate pollen counts will be above normal in the southeastern United States, and most of the East Coast. A recent photo of “pollencopalypse” over Durham, NC, by photographer Jeremy Gilchrist went viral after showing how thick the pollen in the air can be in spring.

Many popular allergy medications can be safely taken by people with heart conditions, but there are some ingredients that can raise blood pressure or interfere with heart medications. As with any medicine, it is best to discuss your options with your doctor or health care provider, but below are some tips to guide you in the allergy medication aisle:

  • Avoid the “D” for decongestants, which can raise blood pressure or cause heart palpitations. Popular allergy medications include decongestants to help relieve allergy symptoms, and manufacturers of these drugs will add “D” to their packaging, such as Claritin-D or Allegra-D.
  • Antihistamines should be okay to use; however check with your doctor to be sure. Evidence shows that antihistamines like Allegra, Claritin and Zyrtec are effective against seasonal allergies and should be fine for people with heart conditions.

Although it is impossible to avoid pollen in areas where it is prevalent, there are other ways to help reduce your symptoms, too. Keep windows and doors closed during the spring to avoid pollen entering your house. In addition, wearing a face mask when stirring up pollen during yard work can also help to keep symptoms at bay.

Few people with heart failure take guideline-recommended drug

Heart failure patients who could possibly benefit from a newer class of drug to lower their heart rate were more likely to take the medication if it was prescribed before hospital discharge rather than in a follow-up doctor’s visit, according to preliminary research presented at the American Heart Association’s Quality of Care and Outcomes Research Scientific Sessions in Arlington, Virginia.

The study team included several researchers from CONNECT-HF and you can read more about the results here.

National Heart Failure Awareness Week: An opportunity to share information and resources with others

February is American Heart Month, and many people may be aware of events such as Go Red for Women, but did you know that heart failure has its own awareness week this month? February 10th-16th is National Heart Failure Awareness Week, organized by the Heart Failure Society of America (HFSA).

National Heart Failure Awareness Week is a great opportunity for people who are living with heart failure to help their loved ones better understand their condition. CONNECT-HF has several resources available, including an explanation of heart failure and Healthy Living Tips. The HFSA also has tools available to download, including learning modules that patients and their caregivers can take together, and an app designed to help patients track their symptoms vital signs and medications.

“Heart failure is an important health issue throughout the year, but we are happy to be a part of helping to promote awareness of this disease through National Heart Failure Awareness Week,” said Dr. Adam DeVore, principal investigator for CONNECT-HF. “We hope our participants share their experiences and resources with friends and family to help others better understand what it is like to live with heart failure.”

In addition to the tools available, HFSA is also sponsoring several national webinars for patients and caregivers during Heart Failure Awareness Week. To learn more about the webinars, go to https://www.hfsa.org/hfweek2019/ and scroll down to see the national webinar options.

CONNECT-HF reaches site activation goal

Congratulations to the CONNECT-HF Team for meeting their total site activation goal of 160 sites in October.

CONNECT-HF is a large-scale, pragmatic, cluster-randomized clinical trial to evaluate the effect of a customized, multifaceted, health system-level quality-improvement (QI) program compared with usual care on heart failure (HF) outcomes and HF quality-of-care metrics, led by principal investigator Adam DeVore, MD. The trial plans to enroll 7040 participants at 160 hospitals across the United States. The goal is to evaluate different ways of improving the overall quality of care available to people with heart failure, and to help them gain the greatest benefit from the treatments and health management advice they receive.

The trial began recruiting sites in April 2017.

“We are so pleased to reach our site activation goal for this study,” said DeVore. “We are learning that the changes hospitals make in CONNECT-HF can be system-wide and impact many more patients than only those in the trial, and we are excited about the potential public health impact in learning how to best manage treatment of heart failure.”

The study will follow participants for one year post discharge.

 

Healthy Fats for Heart Health

Eating healthy foods can be one of the most important actions you can take to protect your heart, but the definition of “healthy” can sometimes seem confusing. Recent research has changed the longtime belief that a healthy diet is also low in fat. Instead, your doctor may recommend eating the right kinds of fat that can be found in a Mediterranean Diet.

The Mediterranean Diet refers to the way people eat in countries that border the Mediterranean Sea. People in these countries eat a lot of fish, olive oil, fruits, and vegetables and often have better health outcomes and longer life expectancy than people in the United States. Although the diet is high in fat, it is mostly monounsaturated and polyunsaturated fat, which can be good for your heart.

The diet focuses on eating healthy fats, and includes fish, olive oil, nuts, and other foods that have high levels of monounsaturated and polyunsaturated fats. These fats can help lower blood cholesterol and the risk of heart disease. You should avoid saturated fats and transfats.

The National Heart, Lung, and Blood Institute recommends eating vegetables, fruits, whole grains, fat-free or low-fat dairy products, fish, lean meats, poultry, eggs, nuts, seeds, soy products, legumes and vegetable oils as part of a heart-healthy diet. It also recommends limiting sodium, saturated and transfats, added sugars, and alcohol. This is considered a healthy eating plan in the U.S.

Some ways to add more healthy fats into your diet include:

  • Eating a handful of nuts
  • Adding nut butter to an apple
  • Eating fish 2-3 times a week
  • Adding avocado to a salad
  • Using full-fat salad dressings and mayonnaise.

The primary differences between the Mediterranean Diet and the healthy U.S. eating plan is that the Mediterranean Diet has less dairy and more fruits. You should discuss any changes to your diet with your doctor, and he or she can help you choose the healthy eating plan that is best for you.

Learn more here:

https://health.gov/dietaryguidelines/2015/guidelines/appendix-4/

https://www.nhlbi.nih.gov/health-topics/heart-healthy-lifestyle-changes#heart-healthy-eating

Staying active in summertime heat

Summertime can be a great time to find new activities to add to your exercise routine. However, higher temperatures can also create new concerns, especially for patients with a diagnosis of heart failure. But the heat doesn’t have to mean you can’t exercise. Described below are tips for exercising in the heat to help you take full advantage of summertime fun. It is a good idea to talk with your doctor before starting a new exercise program.

  • Listen to your body. Increased heat means that your muscles work harder to move, which puts more stress on your heart. If your heart rate feels irregular or you stop sweating, stop exercising and go inside immediately to cool down. Other warning signs include a headache, muscle cramps, dizziness, weakness, nausea or vomiting, or confusion The National Institute of Aging has more information how to be safe in hot weather.
  • Make a schedule and stick to it. The CONNECT-HF activity tracker is a great way to log your workouts and include notes about how you felt during the exercise. This is a useful tool to share with your doctor to help you find the best summer exercise plan for you.
  • Exercise early. Early morning hours are the best time to avoid summertime heat and humidity. It is also the time of day when air quality is at its best. Your local news will alert you when air quality is too low for exercise, or you can check the AirNow.gov website. Lower impact exercise, such as a walk, can be done in the evening, but humidity is often higher after the sun goes down.
  • Wear light, loose fitting clothing. Dark color or tight fitting can increase your body temperature, even performance exercise clothing designed to wick away moisture. You might also want to avoid cotton as it can retain sweat and get heavier as you exercise.
  • Jump in the pool. If your neighborhood or community has an outdoor pool, swimming can be a fun way to get active and stay cool. Many local pools have dedicated lap swim times, and swimming is an excellent way for heart patients to build muscle strength and heart stamina.
  • Explore yoga and tai-chi. Strength and flexibility are very important for overall physical health, and yoga and tai-chi can be a gentle way to increase your strength and flexibility without getting your heart rate up. Many hotels offer yoga on the beach or in a courtyard to help you stay active even while traveling.
  • Stay hydrated. It is important to drink water both before and after your workout, and if you are going on a long walk or run, carry a water bottle with you, too. Freezing the bottle ahead of time means you’ll have an instant cool pack with you and can enjoy cold water during your workout.
  • Stay inside if you are more comfortable. If it’s too hot to be outside, there are many exercises you can do inside your home, at a local gym, or at a mall. Many malls offer walking groups. Check out this information on the benefits of mall walking from the National Institute on Aging at the National Institutes of Health. Another exercise well suited for indoors are chair exercises. The Internet offers a number of videos on chair exercises that can be easily performed anywhere.

Meet a Cardi-Yack: Fredonia

Using her own personal experiences, Fredonia Williams hopes to make a difference in the CONNECT-HF study and in the lives of people recently diagnosed with heart failure. Support for patients with heart failure is extremely important and other patients who are experts by experience are well suited to provide valuable insights to both patients and doctors.

Fredonia is a patient adviser, also known as a Cardi-Yack, in the CONNECT-HF study. Fredonia has had opportunities to interact with heart patients, cardiologists, and researchers. She believes that patient input can help researchers tweak a research question with the ultimate goal of better health for all. We invite you to watch this video to hear from Fredonia on how patients can support other patients, doctors, and researchers.

 

Out with the Old, In with the New: Spring Cleaning Old Habits

Spring is here, and the newly sprouted greenery and blossoming flowers have us all in the mood for a fresh start. What kind of old habits do you want to break? Whether it’s smoking, indulging in sweets, or sitting in front of the television, we all have routines we know aren’t the best for us. The CONNECT-HF Study team encourages people with heart failure to continue working on creating healthy habits. Small changes to your lifestyle may be helpful in controlling heart failure symptoms. Here are three unexpected ways you can spring-clean some old habits and blossom into a new, heart-healthier you.

1. Stop trying to break your old habits.

Yes, this sounds like the opposite of spring cleaning, but hear this out. Most of our brains are not designed to respond well to what are called negative goals, such as: “I’m not going to eat sweets today.” Instead, try framing your goals positively: “After dinner, when I typically want to eat sweets, I will take a walk instead.” The truth is, when we talk about breaking habits, what we really want are new, more positive habits. Instead of thinking about what you can’t have, think of what you will do instead.

2. Talk to yourself.

In the moments before we engage in an old habit, a rapid conversation with ourselves is often going on in our minds. We know we shouldn’t eat that cake, but it’s as if a chorus of supporters live in our brains and come up with reasons why we should. “You deserve this! You’ve had a bad day, and this cake will make it better.” Before you make that choice, force yourself to say these excuses out loud. When you tune into them and listen carefully, they will likely sound a little silly and lose some of their power.

3. Prepare for new habits to feel strange at first.

When we break an old habit, the beginning of the process is the most difficult. Before we feel the positive changes of a new us, our minds try hard to convince us to return to our old ways. It can be mentally exhausting, and we may start to doubt that we have the willpower to sustain our new habit. The trick is to remember that this uncomfortable feeling is temporary, and it will get easier—a lot easier. In fact, your new lifestyle will actually make you a much happier person if you stick with it.

Are you motivated to spring clean your old ways? ‘Tis the season for reinvention, so leave one of your old habits in the dust today! For more helpful tips from the CONNECT-HF Study Team, visit our healthy living tips page.

Read Two CONNECT-HF Publications

CONNECT-HF investigators have teamed up to write two new publications about improving heart failure care and outcomes.

The publications, Improving heart failure health: is there a secret Swedish sauce? and Leveraging Behavioral Economics to Improve Heart Failure Care and Outcomes both look at different ways researchers are trying to help people with heart failure.

About Improving heart failure health: is there a secret Swedish sauce?

Improving heart failure health: is there a secret Swedish sauce? is an editorial comment authored by two CONNECT-HF investigators. It looks at the results of a registry study in Sweden to comment on whether the data was strong enough to claim that patients who took part in the study received better care for heart failure compared to patients who did not take part.

This commentary also looks at an American Study called Get with the Guidelines, to compare it with the Swedish study. The commentary concludes that the evidence published from the Swedish registry study is not enough to say whether it patients received better care by joining in. Finally, the commentary introduces readers to the CONNECT-HF trial and the idea of involving patients in study design. Read this editorial comment here.

About Leveraging Behavioral Economics to Improve Heart Failure Care and Outcomes

Leveraging Behavioral Economics to Improve Heart Failure Care and Outcomes looks at how we can use people’s everyday behaviors to help understand what leads to heart failure, and therefore understand how we can improve life for people with heart failure. This publication looks at why people behave the way they do. One example is the intent-behavior gap, where a patient with heart failure may intend to take their medications every day when they’re first diagnosed, but then find out that it’s harder than they thought and give up. The publication also looks at different ways to change these behaviors, such as signing goal contracts, financial rewards, social rewards, and more. Read this publication here.

Other CONNECT-HF news

In addition to these publications, there have been several news stories published on CONNECT-HF, including one on MobiHealth News and a video on MedScape.

As always, you can stay up to date with recent CONNECT-HF news here. Check back for more news in the future!