(Press-News.org) Doctors should transition their patients from pediatric to adult medical care for congenital heart disease during early adolescence, experts recommend in a scientific statement published in Circulation: Journal of the American Heart Association.
"It's not as simple as getting the name of a new doctor and going to see them when a patient turns 18," said Craig Sable, M.D., co-chair of the statement committee and director of echocardiography and cardiology fellowship training at Children's National Medical Center in Washington, D.C. "There are multiple steps associated with the transition process that need to be started at a very young age, so that by the time these children become adults the process is well under way."
The transition should be a joint effort between the healthcare provider (usually a pediatric heart specialist), the patient and the patient's family that starts when patients are between 12 to 14 years old, Sable said.
Critical steps include:
Select an adult care physician to provide and coordinate comprehensive care;
Offer reproductive/genetic and career counseling;
Secure health insurance;
Educate adult care providers in managing congenital heart disease;
Maintain communication between patients, families and healthcare professionals.
Congenital heart disease occurs before birth and is the most common type of birth defect. These heart disorders are usually relatively mild and treatable.
Most children born with congenital heart disease today survive into adulthood and live normal lives. In the United States, more than half of those affected are now adults.
However, many patients need specialized and uninterrupted medical treatment. Ideally, the transition process minimizes disruption and stress while maintaining appropriate treatment continuity. But less than one-third of adults with congenital heart disease receive care from qualified, trained specialists, Sable said.
"The vast majority of the patients we see are not necessarily the most severe, so there's a real concern that some of the patients who really need care are not seeking it," he said. "The bottom line is to ensure that, as patients grow up, they receive the necessary care."
Beginning in 2008, Sable and his team researched transition literature to identify the most effective practices that they presented in the paper.
###
Co-authors are: Karen Uzark, Ph.D., P.N.P., co-chair; Elyse Foster, M.D., co-chair; Kathy Bjornsen, B.S.N., A.R.N.P.; Mary M. Canobbio, R.N., M.N.; Heidi M. Connolly, M.D.; Thomas P. Graham, M.D.; Michelle Z. Gurvitz, M.D., M.S.; Adrienne Kovacs, Ph.D., C.Psych.; Graham J. Reid, Ph.D., C.Psych.; John G. Reiss, Ph.D.; Paul J. Sagerman, M.D., M.S.; Arwa Saidi, M.B., B.Ch.; Sangeeta Shah, M.D.; Elizabeth Tong, M.S., R.N., C.P.N.P.; and Roberta G. Williams, M.D.
Author disclosures are on the manuscript.
END
Soda and other sugar-sweetened beverages such as fruit drinks are associated with higher blood pressure levels in adults, researchers report in Hypertension: Journal of the American Heart Association.
In the International Study of Macro/Micronutrients and Blood Pressure (INTERMAP), for every extra sugar-sweetened beverage drunk per day participants on average had significantly higher systolic blood pressure by 1.6 millimeters of mercury (mm Hg) and diastolic blood pressure higher by 0.8 mm Hg. This remained statistically significant even after adjusting for differences ...
STANFORD, Calif. — A pediatric brain tumor that causes gruesome suffering is finally yielding its secrets. For the first time, scientists at the Stanford University School of Medicine have cultured human cells from this cancer, Diffuse Intrinsic Pontine Glioma, and used those cells to create an animal model of the disease. Their discoveries will facilitate research on new treatments for DIPG, a tumor of school-aged children that is now almost universally fatal.
The advances come thanks to the parents of young cancer victims, who donated their deceased children's brain ...
BOSTON, Feb. 28, 2011 – A change in the formulation of tenofovir gel, an anti-HIV gel developed for vaginal use, may make it safer to use in the rectum, suggests research presented today at the 18th Conference on Retroviruses and Opportunistic Infections (CROI). In laboratory tests of rectal tissue, researchers from the Microbicide Trials Network (MTN) found the reformulated gel was less harmful to the lining of the rectum than the original vaginal formulation, and just as effective in protecting cells against HIV.
Researchers are now testing the reformulated gel in ...
TEMPE, Ariz. – A team of researchers from Arizona State University, Stanford University and Carnegie Institution for Science has found that converting large swaths of land to bioenergy crops could have a wide range of effects on regional climate.
In an effort to help wean itself off fossil fuels, the U.S. has mandated significant increases in renewable fuels, with more than one-third of the domestic corn harvest to be used for conversion to ethanol by 2018. But concerns about effects of corn ethanol on food prices and deforestation had led to research suggesting that ...
Using underwater speakers to play noise at levels similar to those produced by recreational speedboats, the researchers found that three-spined sticklebacks exposed to even brief noise playback made more foraging mistakes and were less efficient at consuming the available food compared to those in quiet conditions.
Dr Julia Purser, the study's lead author, said: "The fish appeared to be distracted by the addition of noise to their environment. Much as you or I might struggle to concentrate on a difficult assignment when faced with loud construction noise, these stickleback ...
The first findings from the world's largest study of households are now published. The Understanding Society publication reveals a comprehensive snap shot of UK households. Starting in 2009, the year when Britain officially entered recession for the first time since 1991 and the Copenhagen climate summit ended in more questions than answers, the study offers an unprecedented insight into 40,000 UK households as they respond to regional, national and international change.
The publication offers a window into British society in the 21st century. With data on our working ...
Increased hospital spending at high-cost hospitals does not appear to be associated with better short-term survival rates for patients with sepsis, according to a report in the February 28 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
"Sepsis affects approximately 750,000 patients each year in the United States and is in many ways a model condition for examining the relationship between hospital spending and patient outcomes and for identifying potential opportunities to improve the value of hospital care," the authors write as background ...
Older patients are willing to take medications for cardiovascular disease prevention, but only if the drug has much more benefit than risk, according to a report published online first by the Archives of Internal Medicine, one of the JAMA/Archives journals. The paper will be published in the June 27, 2011 print issue of the journal.
"Quality-assurance and pay-for-performance initiatives increasingly encourage adherence to evidence-based guidelines for the prevention or management of particular diseases," the authors provide as background information in the article. "However, ...
Many patients, especially those with limited literacy, may self-administer prescription medications more times a day than is necessary, which may lead to missed or incorrectly administered dosing, according to a report in the February 28 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
"According to the Medical Expenditure Panel Survey, the average adult in the United States fills nine prescriptions annually, while adults older than 65 years fill on average 20 prescriptions a year," the authors write as background information in the article. ...
COLUMBUS, Ohio – New research that reveals how maternal antibodies block an immune response to the measles virus is a first step toward improving current childhood vaccination practices, scientists say.
Maternal antibodies are passed to fetuses during pregnancy and to newborns in their mothers' milk. The antibodies protect infants against disease in the first months of life, but that protection comes at a cost: Their presence also interferes with the generation of a natural immune response to vaccination. As a result, most babies receive measles immunizations at the age ...
