343 - SUPPORTING SUCCESSFUL TRANSITIONS FROM PEDIATRIC TO ADULT CONGENITAL SPECIALITY CARE

Workshop Description: Congenital heart disease (CHD) describes a broad range of cardiac structural abnormalities that are present at birth. With improvements in interventions and care of children born with CHD, there is an increased survival to adulthood. The emergence of a growing population of adults with CHD has resulted in the need to provide support to adolescents transitioning their healthcare from the pediatric CHD care context to the adult CHD care context. Rather than the single occurrence of transfer of care on the patient’s 18th birthday from the pediatric to the adult setting, transition of care is an ongoing process that bridges adolescence and young adulthood and prepares the patient to understand and self-manage their CHD.

Transition is a high-risk time of lapses in specialized CHD care, which is concerning as successful transitions are associated with improved survival and quality of life. Transition entails navigating a new healthcare team and possibly healthcare facility independently, as the burden of responsibility for self-management commonly shifts from caregivers (e.g., parents, guardians) to patients. In addition, patients are required to have knowledge of their CHD and to apply this knowledge to decision-making for careers, lifestyle choices, and relationships. This occurs at a time when people living with CHD are also navigating the usual adolescent and young adult milestones, which include increased independence, beginning post-secondary education or joining the workforce, and living independently of caregivers. This time of increased responsibility has been shown to also be a time of increased anxiety and the need for psychosocial support.

There are RCTs demonstrating improved knowledge and self-management skills with transition interventions and guidelines providing broad recommendations for best practices for a successful transition. The majority of the RCTs have involved a uni-disciplinary, education and self-management-focused transition program. These RCTs do not align with guideline recommendations, which suggest a multidisciplinary approach to supporting self-management, knowledge development, and psychological well-being. This incongruence may be a contributing factor to the inconsistent uptake of transition programs among Canadian centers providing specialized CHD care.

Our workshop addresses this incongruence and aims to build knowledge and capacity among Canadian pediatric and adult CHD providers to support them to develop multidisciplinary, tailored, patient-focused transition programs. We will achieve this aim through three interactive presentations and an interactive question-and-answer period.

Interactive and Engagement Activities Description: Interactivity and engagement will occur in three ways and will exceed 25% of the total education time. First, polling via ARS will be used. There will be questions designed to encourage attendees to both reflect on their current knowledge/ practice and to apply information provided in the presentations. Second, the second presenter is a person with lived experience, who is sharing what is essentially his case presentation. This lived experience case presentation is intended to encourage reflection among attendees. Third, there will be a Q&A period after the three presentations allowing attendees to ask questions via ARS and live.