HeFSSA News November and Annual Report 2013

Nov 19, 2013

The Heart Failure Society of South Africa (HeFSSA) worked diligently during this year to ensure that we successfully achieved the goals that we set for the society for 2013: To continue to provide value to the SA Heart Association, colleagues, industry and to our patients and to acknowledge our responsibility towards the communities in which we practice and our sponsors.

The HeFSSA Exco who is the back bone of the society and who worked meticulously throughout this year consists of a number of cardiologists in public and private sector with a passion for Heart Failure: Eric Klug (President), Martin Mpe (Vice-President), Darryl Smith (Treasurer) and Jens Hitzeroth (Secretary). Representatives: Karen Sliwa, Pro Obel, Cristina Radulescu, Sandrine Lecour and Tony Lachman. HeFSSA is supported by loyal corporate members committed to especially education in heart failure (generous educational grants). Our sincere appreciation goes to AstraZeneca, Boston Scientific, Servier, Pharma Dynamics, Merck and Medtronic.

The HeFSSA Practitioners Programcontinues to be of great value to the medical community as well as the pharmaceutical and device industry and it is also the main vehicle we use to achieve our educational goals. The program started in 2010 with meetings in the 6 major centers across South Africa and approximately 200 GP’s in total attended. Since thenwe have grown and we have established the HeFSSA Heart Failure program in the established areas as well as in peripheral areas. This year we hosted CPD accredited meetings in 16 areas and 450 practitioners attended. The format was patient case-based discussions as well as a South African update on the ESC guidelines 2012. The slides were prepared by Eric Klug, Martin Mpe, Darryl Smith and Jens Hitzeroth and received numerous positive comments from both attendees as well as faculty members (high quality and educational value).

The attendees received a HeFSSA Business Card(This card details "how to contact us" and hopes to encourage traffic to the website for on-going education), a comprehensive and well designed HF-REF diagnosis and treatment algorithm in the form of an A2 poster (based in the ESC Guidelines published in 2012) and also a hard copy document on the South African perspective on the 2012 ESC Heart Failure guidelines. Practitioners also have the opportunity to earn 3 extra CPD points by completing CME questionnaires. This system enables doctors to earn CPD points by completing an online CPD accredited questionnaire. On successful completion of the questionnaire a PDF certificate is electronically issued.

The faculty members for 2013 were: E Klug, D Smith, DP Naidoo, AS Mitha B Vezi, K Sliwa, T Lachman, N Van Der Merwe, S Middlemost, J Hitzeroth, M Makotoko, C Badenhorst, R Gopal, R Jardine, P Obel, EN Maree, J Vorster and A Snyders. We are thankful for their commitment towards HeFSSA, the hours travelled and the time spent away from their families.

Feedback from delegates was extremely positive, stressing the value of these programs and the need for its continuance.

The Heart Failure Society of South Africa (HeFSSA) perspective on the European Society of Cardiology (ESC) 2012 chronic heart failure guideline:This perspective has been compiled on behalf of HeFSSA and is based on the ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012.  The objective is to highlight new changes in the diagnosis and treatment of chronic heart failure with particular emphasis on areas that are relevant to SA. We came to the conclusion that randomised clinical trials are a crucial, but not the only, guide in treating HF-REF patients. There always remain questions that are unanswered and groups of patients not studied, so prudent clinical decisions are required. The focus is on heart failure with reduced fraction (HF-REF) (i.e. ejection fraction <50%). We have recommended interventions in symptomatic patients with HF-REF in general to clarify the ‘grey area’ between the ESC guidelines definition of REF (<50%) and the predefined ejection fraction used in randomised heart failure trials (<35%).

The South African Heart Association (SA Heart) is an affiliate of the European Society of Cardiology (ESC). SA Heart endorses ESC treatment guidelines with modification to suit local circumstances. The Heart Failure Society of South Africa (HeFSSA) is a special interest group of SA Heart.

This document was developed by Dr M T Mpe, with the help of Drs E Klug, D Smith, J Hitzeroth and Prof K Sliwaon behalf of the Heart Failure Society of South Africa and is published as a supplement in the SA Heart Medical Journal. [S Afr Med J 2013; 103(9 Suppl 2):661-667. DOI:10.7196/SAMJ.7319] HeFSSA is also actively distributing this document in the market.

HeFSSA has established the annual “HeFSSA Travel Award” to help enhance local expertise and interest in heart failure in South Africa. We hope that knowledge gained will be shared through appropriate channels with colleagues. This award is available to cardiologists, cardiology fellows or physicians with a special interest in heart failure. The applicant’s annual SA Heart and HeFSSA’s membership fees must be paid-up. The accredited congress/educational program must have a focus on Heart Failure. The maximum grant value is R 50,000 (Fifty Thousand Rand) and can be utilised towards airfare (economy class), congress registration, and accommodation. Please contact the HeFSSA office or go to http://www.hefssa.org/static/education-at-hefssa/ to apply online for the 2014 award.

This year the award went to two worthy recipients, Dr Kemi Tibazarwa from UCT who attended PASCAR 2013 congress in Senegal in May of this year as well as Dr Alfonso Pecoraro from US, who attended the 2013 ESC congress in Amsterdam.

A major new educational initiative was made available in 2013 with the ideal recipient newly qualified cardiologists with a dedicated interest in heart failure. The Zurich Heart House, in collaboration with the ESC and the Heart Failure Association, has developed the new Postgraduate Course of Heart Failure(PCHF) which is certified by the University of Zurich and leads to a Certificate of Advanced Studies (CAS). All Heads of departments were offered the opportunity to nominate one candidate for the two spaces available for South Africa (out of 40 worldwide). The course starts in January 2014 and ends October 2015. The names of the recipients will be made known in due course. HeFSSA like to thank Servier for the unrestricted educational grant which includes the cost of the course, flights and accommodation for all the modules.

To further the achievement of our goals, we are also involved in the promotion of research programs. The World Federation GAPS survey in Heart failure has been concluded and we will focus on the Inter-CHF program for 2013. Prof Karen Sliwa has been approached by McMaster University to spearhead the Inter-CHF study in South Africa:

This will be the largest systematic evaluation of heart failure (HF) in lower and middle income countries in Africa, Asia and South America. This registry will describe the causes, clinical risk factors and burden of disease, document the prevalent approaches to patient management, and identify gaps in the care of HF patients. This registry will also examine patient and physician knowledge and perceptions towards HF, and identify barriers to prevention and treatment, thereby suggesting possible solutions, which may be evaluated in future studies

Such information will also be critical for the development of locally “sensitive” guidelines, research programs, and possible policies and interventions. The aim is to capture the information of at least 400 patients in South-Africa.

The HeFSSA websiteis continually updated to remain relevant. The website has an online system which enables doctors to earn CPD points by completing CPD accredited questionnaires online.  On successful completion of the questionnaire a PDF certificate is electronically issued. We currently have 2 questionnaires live pertaining to The HeFSSA Practitioners update as well as an ethics questionnaire on PMB’s: “What does the law say?” Please visit the website at www.hefssa.org and complete your questionnaire today!                        

HeFSSA will be involved in the SA Heart Congress, 16 – 19 October 2014,which is organised by SA Heart Durban Branch.  Eric Klug will represent HeFSSA on the scientific committee.

HeFSSA will in 2014 continue to focus on GP education in Heart Failure (SA, Namibia and possibly expanding to Botswana, Mozambique and Kenya), General Cardio Updates (preceding cardio congresses in SA) as well as a Funder Indaba and Patient Empowerment Program are on the cards. We will continue to offer Face to Face CPD accredited courses augmented by CPD accredited web based study material and related questionnaires. Acute HF will, in addition to chronic, definitely be a focus area for 2014

HeFSSA encourages all parties who want to be involved in heart failure to contact the HeFSSA office (George Nel, info@hefssa.org or 083 458 5954 and Sanette Zietsman sanette@medsoc.co.za or 083 253 5212)

Best wishes to you and loved ones for the festive season!

Eric Klug

HeFSSA President




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