Healthcare transition for youth with heart disease: A clinical trial

Andrew S. Mackie, Sunjidatul Islam, Joyce Magill-Evans, Kathryn N. Rankin, Cheri Robert, Michelle Schuh, David Nicholas, Isabelle Vonder Muhll, Brian W. McCrindle, Yutaka Yasui, Gwen R. Rempel

    Research output: Contribution to journalJournal Articlepeer-review

    106 Citations (Scopus)

    Abstract

    Objectives: Adolescents with heart disease have complex health needs and require lifelong cardiology follow-up. Interventions to facilitate paediatric to adult healthcare transition are recommended, although outcomes are unknown. We sought to determine the impact of a transition intervention on improving knowledge and self-management skills among this population. Methods: We conducted a clinical trial of 15-17 year olds with moderate or complex congenital heart disease (CHD) or cardiomyopathy. Participants were systematically allocated to either usual care (controls) or a 1 h nurse-led one-on-one teaching session about their heart. Allocation was determined by week of attendance in the cardiology clinic. The primary outcome was change in Transition Readiness Assessment Questionnaire (TRAQ) score at 6 months, possible scores ranging from 1 (low) to 5 (optimal). Cardiac knowledge (MyHeart score, range 0-100) was a secondary outcome. Analysis was intention to treat. Results: Of 58 participants (48% female), 52 had CHD and 6 had cardiomyopathy. 27 were allocated to the intervention group; 3 declined the intervention and received usual care. When comparing the intervention group with the usual care group at 6 months postintervention, the mean self-management TRAQ score was 3.59 (±0.83) vs 3.16 (±1.05), respectively (p=0.048, adjusted for baseline score); the mean selfadvocacy TRAQ score was 4.38 (±0.56) vs 4.01 (±0.95) (p=0.18) and the mean MyHeart score was 75% (±15) vs 61% (±25) ( p=0.019). Conclusions: A 1 h nurse-led transition intervention resulted in a signi ficant improvement in selfmanagement and cardiac knowledge scores. An educational intervention should be routine for youth with congenital or acquired heart disease.

    Original languageEnglish
    Pages (from-to)1113-1118
    Number of pages6
    JournalHeart
    Volume100
    Issue number14
    DOIs
    Publication statusPublished - Jul. 2014

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