Adult congenital cardiac life-long needs evaluation in a low-middle income country, Pakistan

Ladak, Laila Akbar; Pearson, D; Jenkins, Kathy J.; Amanullah, Muneer; Ahmad, Waris; Schmeck, Kaitlin Doherty; Verstappen, Amy; Hasan, Babar

doi:10.47391/jpma.013

Cited by 2 publications

(5 citation statements)

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“…6,16,23,36 Disjointed postoperative follow-up has negative consequences for children who may grow up and require life-long care for CHD. 35 Patients with ACHD often do not have specialized care to manage their unique long-term postoperative complications, such as arrhythmias and heart failure. Further, a lack of CHD registries preclude the ability to follow and study ACHD in the long term.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Further, a lack of CHD registries preclude the ability to follow and study ACHD in the long term. 9,35 Lastly, given the large number of children who survive into adulthood with CHD despite not having undergone surgery, there is a significant need to address the health care needs of ACHD, including with surgical intervention. 37…”

Section: Resultsmentioning

confidence: 99%

“…The paradigm in LMICs involve adult CHD patients being followed by pediatric cardiologists, resulting in lapses of knowledge in age specific conditions and sequelae. 35 The transfer of patients with CHD from one physician to adult cardiac care is often lacking. 35…”

Section: Inadequate Postoperative Caregiver Counseling and Educationmentioning

confidence: 99%

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Barriers to Accessing Congenital Heart Surgery in Low- and Middle-Income Countries: A Systematic Review

Cheng,

Heo,

Joos

et al. 2023

World J Pediatr Congenit Heart Surg

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Background Congenital heart disease (CHD) is the most common major congenital anomaly. Ninety percent of children with CHD are born in low- and middle-income countries (LMICs), where over 90% of patients lack access to necessary treatments. Reports on barriers to accessing CHD care are limited. Accordingly, it is difficult to design evidence-based interventions to increase access to congenital cardiac surgical care in LMICs. Objective We performed a qualitative systematic review to understand barriers to accessing congenital cardiac surgical care in LMICs. Methods We conducted a search of Ovid MEDLINE and CINAHL databases to identify relevant articles from January 2000 to May 2021. We then used a thematic analysis to summarize qualitative data into a framework of preoperative, perioperative, and postoperative barriers. Results Our search yielded 1,585 articles, of which 67 satisfied the inclusion criteria. Notable preoperative barriers included delayed diagnosis, insufficient caregiver education, financial constraints, difficulty reaching treatment centers, sociocultural stigma of CHD, sex-based discrimination of patients with CHD, and Indigeneity. Perioperative barriers included lack of hospital resources and workforce, need for prolonged hospitalization, and strained physician–patient relationships. Many patients faced barriers postoperatively and into adulthood due to a shortage of critical care resources, inadequate caregiver counseling and patient education, lack of follow-up, and debt from hospital bills and missed work. Conclusion Reducing neonatal and childhood mortality begins with recognizing barriers to accessing health care. Our systematic review identifies and classifies challenges in accessing CHD in LMICs and suggests solutions to major barriers.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Inadequate Postoperative Caregiver Counseling and Educationmentioning

confidence: 99%

See 2 more Smart Citations

Barriers to Accessing Congenital Heart Surgery in Low- and Middle-Income Countries: A Systematic Review

Cheng,

Heo,

Joos

et al. 2023

World J Pediatr Congenit Heart Surg

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show abstract

“…PCHD, even when operated, is a lifelong condition due to the need for follow-up, risk of reintervention, and risk of comorbidities. 14 However, a lack of primary access to tertiary cardiovascular care 10 as well as high rates of loss to follow-up over time or during transition into adulthood results in poor continuity of care. 15 Disparities have been observed in both high-income countries and LMICs; however, they are most pressing in the latter.…”

mentioning

confidence: 99%