Strategies to Aid Successful Transition of Adolescents with Congenital Heart Disease: A Systematic Review
The majority of patients born with congenital heart disease (CHD) need lifelong surveillance with serial clinical attendance and examinations. However, loss of follow-up (namely no documented follow-up for 3 years or more) is a recognised common problem since it is often related to remarkable worsen...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/3/423 |
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| author | Pier Paolo Bassareo Massimo Chessa Giovanni Di Salvo Kevin Patrick Walsh Colin Joseph Mcmahon |
| author_facet | Pier Paolo Bassareo Massimo Chessa Giovanni Di Salvo Kevin Patrick Walsh Colin Joseph Mcmahon |
| author_sort | Pier Paolo Bassareo |
| collection | DOAJ |
| description | The majority of patients born with congenital heart disease (CHD) need lifelong surveillance with serial clinical attendance and examinations. However, loss of follow-up (namely no documented follow-up for 3 years or more) is a recognised common problem since it is often related to remarkable worsening in the health of CHD patients with increased morbidity and mortality. Transitioning from paediatric to adult care has proven to be the most vulnerable point in the care of these subjects. As such, a systematic review was carried out to ask the following questions: What is the percentage of loss of follow-up worldwide? Are there regional fluctuations in the percentage? Is there a link between loss of follow-up and the complexity of CHD? What strategies should be employed to lower the risk of discontinuity in care? The most recent worldwide averaged loss of follow-up is 26.1%, with significant fluctuations across continents and countries. This percentage is even higher (31.9%) when one includes all untraceable patients, presuming that they are not having any cardiac follow-up. The highest discontinuity of care was reported in the USA and in patients with simple CHD. Planning the rules of transition seems to be one of the most reliable tools to minimise the number of CHD patients who are lost in transition. Recalling patients, with general practitioners who are crucial in readdressing half of the lost to follow-up CHD patients to adult CHD specialists, and a good relationship between paediatric cardiologists and the adult CHD team are two other valuable strategies in aiding successful transition. |
| first_indexed | 2024-03-11T06:45:39Z |
| format | Article |
| id | doaj.art-602e014e729f4d58bbc823e68fdb4b77 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-11T06:45:39Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-602e014e729f4d58bbc823e68fdb4b772023-11-17T10:20:01ZengMDPI AGChildren2227-90672023-02-0110342310.3390/children10030423Strategies to Aid Successful Transition of Adolescents with Congenital Heart Disease: A Systematic ReviewPier Paolo Bassareo0Massimo Chessa1Giovanni Di Salvo2Kevin Patrick Walsh3Colin Joseph Mcmahon4School of Medicine, University College of Dublin, D07 R2WY Dublin, IrelandAdult Congenital Heart Disease UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS-Policlinico San Donato, San Donato Milanese, Vita Salute San Raffaele University, 20132 Milan, ItalyExperimental Cardiology, Paediatric Research Institute (IRP), Division of Paediatric Cardiology, Department of Women’s and Children’s Health, University of Padua, 35128 Padua, ItalySchool of Medicine, University College of Dublin, D07 R2WY Dublin, IrelandSchool of Medicine, University College of Dublin, D07 R2WY Dublin, IrelandThe majority of patients born with congenital heart disease (CHD) need lifelong surveillance with serial clinical attendance and examinations. However, loss of follow-up (namely no documented follow-up for 3 years or more) is a recognised common problem since it is often related to remarkable worsening in the health of CHD patients with increased morbidity and mortality. Transitioning from paediatric to adult care has proven to be the most vulnerable point in the care of these subjects. As such, a systematic review was carried out to ask the following questions: What is the percentage of loss of follow-up worldwide? Are there regional fluctuations in the percentage? Is there a link between loss of follow-up and the complexity of CHD? What strategies should be employed to lower the risk of discontinuity in care? The most recent worldwide averaged loss of follow-up is 26.1%, with significant fluctuations across continents and countries. This percentage is even higher (31.9%) when one includes all untraceable patients, presuming that they are not having any cardiac follow-up. The highest discontinuity of care was reported in the USA and in patients with simple CHD. Planning the rules of transition seems to be one of the most reliable tools to minimise the number of CHD patients who are lost in transition. Recalling patients, with general practitioners who are crucial in readdressing half of the lost to follow-up CHD patients to adult CHD specialists, and a good relationship between paediatric cardiologists and the adult CHD team are two other valuable strategies in aiding successful transition.https://www.mdpi.com/2227-9067/10/3/423adult congenital heart diseaseloss of follow-updiscontinuity in carecongenital heart diseasetransitionepidemiology |
| spellingShingle | Pier Paolo Bassareo Massimo Chessa Giovanni Di Salvo Kevin Patrick Walsh Colin Joseph Mcmahon Strategies to Aid Successful Transition of Adolescents with Congenital Heart Disease: A Systematic Review Children adult congenital heart disease loss of follow-up discontinuity in care congenital heart disease transition epidemiology |
| title | Strategies to Aid Successful Transition of Adolescents with Congenital Heart Disease: A Systematic Review |
| title_full | Strategies to Aid Successful Transition of Adolescents with Congenital Heart Disease: A Systematic Review |
| title_fullStr | Strategies to Aid Successful Transition of Adolescents with Congenital Heart Disease: A Systematic Review |
| title_full_unstemmed | Strategies to Aid Successful Transition of Adolescents with Congenital Heart Disease: A Systematic Review |
| title_short | Strategies to Aid Successful Transition of Adolescents with Congenital Heart Disease: A Systematic Review |
| title_sort | strategies to aid successful transition of adolescents with congenital heart disease a systematic review |
| topic | adult congenital heart disease loss of follow-up discontinuity in care congenital heart disease transition epidemiology |
| url | https://www.mdpi.com/2227-9067/10/3/423 |
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