Changes in care patterns associated with a transition program in adolescents with congenital heart disease: A single center study

Abstract

BackgroundTransition programs educate patients on the importance of continued congenital heart disease specialized care. ObjectiveThe aim of this study was to evaluate changes in the rate of unplanned cardiac hospitalizations after the implementation of a formal transition program in adolescent and young adult congenital heart disease patients. MethodsIn 2016, a formal transition program began at our institution, whereby all patients ≥ 16 years/old with congenital heart disease seen in the pediatric cardiology clinic met with an adult congenital heart disease nurse to discuss transition-related topics. A chart review was performed to determine the difference in unplanned cardiac hospitalizations in control patients seen in the pediatric cardiology clinic before initiation of the transition program (years 2013–2015) compared with transition patients seen after at least 1 transition visit (years 2016–2018). ResultsA total of 303 control CHD patients (control group) were compared with 350 transition CHD patients (transition group). The rate of unplanned cardiac hospitalizations was significantly lower for the transition group after a transition visit compared to control patients (0.004 hosp/pt/yr vs. 0.019 hosp/pt/yr, p = 0.008). Being in the transition group was independently associated with a lower rate of unplanned cardiac hospitalizations. Those in the transition group had a higher rate of transfer to an adult congenital cardiologist (47% vs 38%, p = 0.034). ConclusionBeing in the transition group resulted in a lower rate of unplanned cardiac hospitalizations and an increased frequency of transfer to an adult congenital cardiology center. This study reinforces the importance of structured transition programs to educate and ensure care continuity in patients transferring to adult congenital heart disease care.