Transition from pediatric to adult cardiology care in congenital heart disease: contemporary considerations.

Advancements in diagnostic techniques and procedural innovations for patients with congenital heart disease (CHD) over the past 3-4 decades have led to an expected survival to adulthood rate of over 95%. However, at least 30% of adolescents and emerging adults with CHD experience a prolonged gap in care or are lost to follow-up. Patients experiencing a gap are more likely to have adverse outcomes, so coordinated transition and transfer programs between pediatric and adult care are essential. This review builds on the foundation set by recent US and European consensus statements and examines the current literature regarding transition and transfer of care for patients with CHD. We present a narrative review on transition of care in CHD summarizing contemporary considerations and emphasizing a comprehensive approach. To date, most research has focused on the phases before and around the point of transfer. Despite great efforts in improving processes, significant knowledge gaps remain in the optimization of transition and transfer. Novel programs have demonstrated short-term improvements in disease knowledge but have not consistently addressed other outcomes such as self-management, healthcare utilization, social interactions, and quality of life. In addition, effects on long term medical outcomes such as hospitalizations or mortality are unknown.

Conclusion

There is a paucity of data on the implementation and impact of interventions for short term and post-transfer outcomes of CHD patients. Findings in this review suggest further research is needed to explore transition and transfer protocols and determine effectiveness and applicability in multiple healthcare settings.