This article is more than 5 years old. Information may no longer be current.
Many pediatric cardiologists treat adult patients with congenital heart disease
Click Here to Manage Email Alerts
A significant proportion of patients with adult congenital heart disease are receiving care from pediatric cardiologists, according to survey results recently published in the Journal of the American College of Cardiology.
Researchers examined the results of a cross-sectional survey that was distributed to randomly selected US pediatric cardiologists.
Of the 257 respondents that met inclusion criteria, pediatric cardiologists who provide care to patients aged older than 11 years, 79% reported that they provide care to adults. Respondents were in practice for 18.2 years; 70% were men; and 72% were affiliated with academic institutions.
Participants reported adult comorbidities as the most commonly perceived patient characteristic prompting referral to adult congenital heart disease care (83%). Emotional attachment of parents (87%) and patients (86%) to the pediatric cardiologist was the most perceived barrier to adult congenital heart disease care. Pediatric cardiologists also reported clinician attachment to the patient/family (70%) as a barrier, more commonly identified by respondents who were affiliated with an academic institution. A lack of qualified adult congenital heart disease care providers was reported by 76% of pediatric cardiologists as a barrier as well. However, providers with an academic institutional affiliation were less likely to perceive this as a barrier to adult congenital heart disease care (P=.002).
“Most US pediatric cardiologists provide care to adults and are hesitant to transfer age-appropriate patients to internal medicine specialists. Reasons seem to include widely perceived lack of expert [adult congenital heart disease] caregivers as well as sensed emotional bonding of patients or families to and from caregivers. Transfer of care seems to be commonly triggered by comorbidities acquired in adulthood. Knowledge of referral patterns and perceived barriers to care can inform health care strategists as they face such in the development of educational, transition, and transfer programming aimed at retaining patients within lifelong, coordinated [congenital heart disease] care and achieving optimal outcomes for patients, families and clinicians,” the researchers wrote.
Disclosure: This research was funded in part by the Children’s Hospital Boston Program for Patient Safety and Quality and the Dunlevie Foundation. One of the study researchers reports being a consultant to Novartis and a member of the advisory board to Genentech. The other researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts