Adolescents and Adults With Congenital Heart Disease: Why Are They Lost to Follow-Up?

World J Pediatr Congenit Heart Surg. 2023 May;14(3):357-363. doi: 10.1177/21501351221149897. Epub 2023 Feb 23.

Abstract

Almost 90% of infants with congenital heart disease (CHD) now reach adulthood but require long-term surveillance to recognize and manage residual and/or evolving lesions. Yet many are lost to follow-up. A scoping review identified four specific domains that pose barriers to consistent follow-up. There are multiple issues associated with transition from pediatric to adult care which included-the lack of a seamless transfer, the establishment of a new trusting relationship, promoting the right balance of patient autonomy and addressing knowledge gaps. Additional issues related to logistic problems of time, distance, cost, and the availability of specialized care, are further compounded by the psychosocial factors and the heterogeneity of the cardiac abnormality affecting our patients. Further study of all these issues is warranted to improve ongoing engagement.

Keywords: congenital heart disease; continuity of care; patient engagement/acceptance of healthcare; transition to adult services.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Heart Defects, Congenital* / psychology
  • Heart Defects, Congenital* / surgery
  • Humans
  • Lost to Follow-Up
  • Transition to Adult Care*