期刊
EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES
卷 9, 期 4, 页码 351-357出版社
OXFORD UNIV PRESS
DOI: 10.1093/ehjqcco/qcad014
关键词
Congenital heart disease; Transition; Adolescent medicine; Education; Learning disability
Less than one-third of adolescents with congenital heart disease (CHD) successfully transition to adult care and miss out on education about their condition. We assessed the efficacy of our transition clinic and identified factors associated with successful transition.
Aims Less than one-third of adolescents with congenital heart disease (CHD) successfully transition to adult care, missing out on education of their cardiac condition, and risking loss to follow-up. We assessed the efficacy of our transition clinic on patient education and empowerment and identified correlates of successful transition. Methods and results Overall, 592 patients were seen at least once in our transition service between 2015 and 2022 (age 15.2 +/- 1.8 years, 47.5% female). Most adolescents (53%) had moderate CHD, followed by simple (27.9%) and severe (19.1%) CHD. Learning disability (LD) was present in 18.9% and physical disability (PD) in 4.7%. In patients without LD, knowledge of their cardiac condition improved significantly from the first to the second visit (naming their condition: from 20 to 52.3%, P < 0.0001; describing: 14.4-42.7%, P < 0.0001; understanding: 26.1-60.7%, P < 0.0001), and from the second to the third (naming: 67.4%, P = 0.004, describing: 61.4%, P < 0.001, understanding: 71.1%, P = 0.02;). Patients with LD did not improve their disease knowledge over time (all P > 0.05). Treatment adherence and management involvement, self-reported anxiety, and dental care awareness did not change over time. Successful transition (attendance of >= 2 clinics) was achieved in 49.3%. Younger age at the first visit, simpler CHD, and absence of PD were associated with successful transition. Conclusion A transition service positively impacts on patient education and empowerment in most CHD adolescents transitioning to adult care. Strategies to promote a tailored support for patients with LD should be sought, and earlier engagement should be encouraged to minimize follow-up losses.
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