Transition of care from paediatric to adult services in cardiology
- Department of Adult Congenital Heart Disease, The Queen Elizabeth Hospital, Birmingham, UK
- S A Thorne, Department of Adult Congenital Heart Disease, The Queen Elizabeth Hospital, Birmingham B15 2NQ, UK;
- Accepted 16 April 2007
The outlook for children born with congenital heart disease continues to improve as a result of advances in paediatric cardiac surgery, catheter interventions, medical and perioperative management and imaging techniques. Most patients are now expected to live to adulthood, leading to a significant increase in the population of adults with congenital heart disease.1–3 These young people need to be supported as they make the transition into adulthood; they must be encouraged to take responsibility for their own health and to make informed decisions regarding careers and lifestyle.
Transition is a generic process that applies to all children and adolescents with chronic disease, including those with cardiac, diabetes, renal, rheumatological and respiratory conditions. The transition of care from child to adult healthcare systems must be seen as a continuous process, not a single event. It may be defined as “a purposeful, planned process that addresses the medical, psychosocial and educational/vocational needs of adolescents and young adults with chronic physical and medical conditions as they move from child-centred to adult-orientated health care systems”.4 The transition period is not completed on entrance to adult care and is only successfully achieved when the patient is empowered to take responsibility for their own health and lifestyle, often when they are in their mid-20s. In some patients, this period may never end and in each patient this process is age and development dependent.
Congenital heart disease affects patients’ lives in a number of ways and addressing the issues of education, employment and sports as well as relationships, healthcare, reproduction and lifestyle at an early stage will optimise patients’ quality of life. The benefits of a well-planned transition include improvements in clinical, educational and social outcomes for young people.5 6
The aim of this review is to highlight best practice for transition …