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Ambulatory Care in Adult Congenital Heart Disease—Time for Change?
Background: The adult congenital heart disease (ACHD) population is growing in size and complexity. This study evaluates whether present ambulatory care adequately detects problems and considers costs. Methods: A UK single-centre study of clinic attendances amongst 100 ACHD patients (40.4 years, med...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9000074/ https://www.ncbi.nlm.nih.gov/pubmed/35407666 http://dx.doi.org/10.3390/jcm11072058 |
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author | Coats, Louise Chaudhry, Bill |
author_facet | Coats, Louise Chaudhry, Bill |
author_sort | Coats, Louise |
collection | PubMed |
description | Background: The adult congenital heart disease (ACHD) population is growing in size and complexity. This study evaluates whether present ambulatory care adequately detects problems and considers costs. Methods: A UK single-centre study of clinic attendances amongst 100 ACHD patients (40.4 years, median ACHD AP class 2B) between 2014 and 2019 and the COVID-19 restrictions period (March 2020–July 2021). Results: Between 2014 and 2019, there were 575 appointments. Nonattendance was 10%; 15 patients recurrently nonattended. Eighty percent of appointments resulted in no decision other than continued review. Electrocardiograms and echocardiograms were frequent, but new findings were rare (5.1%, 4.0%). Decision-making was more common with the higher ACHD AP class and symptoms. Emergency admissions (n = 40) exceeded elective (n = 25), with over half following unremarkable clinic appointments. Distance travelled to the ACHD clinic was 14.9 km (1.6–265), resulting in 433–564 workdays lost. During COVID 19, there were 127 appointments (56% in-person, 41% telephone and 5% video). Decisions were made at 37% in-person and 19% virtual consultations. Nonattendance was 3.9%; there were eight emergency admissions. Conclusion: The main purpose of the ACHD clinic is surveillance. Presently, the clinic does not sufficiently predict or prevent emergency hospital admissions and is costly to patient and provider. COVID-19 has enforced different methods for delivering care that require further evaluation. |
format | Online Article Text |
id | pubmed-9000074 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-90000742022-04-12 Ambulatory Care in Adult Congenital Heart Disease—Time for Change? Coats, Louise Chaudhry, Bill J Clin Med Article Background: The adult congenital heart disease (ACHD) population is growing in size and complexity. This study evaluates whether present ambulatory care adequately detects problems and considers costs. Methods: A UK single-centre study of clinic attendances amongst 100 ACHD patients (40.4 years, median ACHD AP class 2B) between 2014 and 2019 and the COVID-19 restrictions period (March 2020–July 2021). Results: Between 2014 and 2019, there were 575 appointments. Nonattendance was 10%; 15 patients recurrently nonattended. Eighty percent of appointments resulted in no decision other than continued review. Electrocardiograms and echocardiograms were frequent, but new findings were rare (5.1%, 4.0%). Decision-making was more common with the higher ACHD AP class and symptoms. Emergency admissions (n = 40) exceeded elective (n = 25), with over half following unremarkable clinic appointments. Distance travelled to the ACHD clinic was 14.9 km (1.6–265), resulting in 433–564 workdays lost. During COVID 19, there were 127 appointments (56% in-person, 41% telephone and 5% video). Decisions were made at 37% in-person and 19% virtual consultations. Nonattendance was 3.9%; there were eight emergency admissions. Conclusion: The main purpose of the ACHD clinic is surveillance. Presently, the clinic does not sufficiently predict or prevent emergency hospital admissions and is costly to patient and provider. COVID-19 has enforced different methods for delivering care that require further evaluation. MDPI 2022-04-06 /pmc/articles/PMC9000074/ /pubmed/35407666 http://dx.doi.org/10.3390/jcm11072058 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Coats, Louise Chaudhry, Bill Ambulatory Care in Adult Congenital Heart Disease—Time for Change? |
title | Ambulatory Care in Adult Congenital Heart Disease—Time for Change? |
title_full | Ambulatory Care in Adult Congenital Heart Disease—Time for Change? |
title_fullStr | Ambulatory Care in Adult Congenital Heart Disease—Time for Change? |
title_full_unstemmed | Ambulatory Care in Adult Congenital Heart Disease—Time for Change? |
title_short | Ambulatory Care in Adult Congenital Heart Disease—Time for Change? |
title_sort | ambulatory care in adult congenital heart disease—time for change? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9000074/ https://www.ncbi.nlm.nih.gov/pubmed/35407666 http://dx.doi.org/10.3390/jcm11072058 |
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