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Implementation of Developmental Screening Guidelines for Children with Congenital Heart Disease
Stacie Knutson1, Michael S Kelleman2, Lazaros Kochilas3
1Division of Cardiology, Department of Pediatrics, University of Minnesota, Minneapolis, MN.
Insights
Pediatric primary care providers show low awareness of American Heart Association guidelines for children with congenital heart disease (CHD). Many do not screen for developmental issues, highlighting a need for better education and cardiology collaboration.
Area of Science:
- Pediatric cardiology
- Developmental pediatrics
- Primary care medicine
Background:
- Congenital heart disease (CHD) is associated with significant neurodevelopmental risks.
- The American Heart Association (AHA) released guidelines in 2012 for managing these developmental abnormalities.
- Effective implementation of these guidelines is crucial for improving long-term outcomes in children with CHD.
Purpose of the Study:
- To evaluate awareness and implementation of the 2012 AHA guidelines among pediatric primary care providers.
- To assess current neurodevelopmental screening practices for children with CHD in primary care settings.
- To identify barriers hindering the adoption of AHA guidelines in clinical practice.
Main Methods:
- An online survey was distributed to pediatricians and family physicians in Minnesota.
- The survey assessed awareness of AHA guidelines, current screening and referral practices, and perceived barriers.
- Data were analyzed from 326 responding providers, including those who care for children with CHD.
Main Results:
- Only 21% of surveyed providers were aware of the 2012 AHA guidelines.
- Referrals for neurodevelopmental concerns were often nonspecific to CHD.
- Few providers (7%) received guidance from pediatric cardiologists on neurodevelopmental screening for CHD patients.
Conclusions:
- There is a significant gap in provider awareness and adherence to AHA guidelines for neurodevelopmental screening in children with CHD.
- Enhanced education for primary care providers regarding CHD-related developmental risks is necessary.
- Increased collaboration between primary care and pediatric cardiology is essential to improve developmental outcomes for children with CHD.
Objectives:
To assess awareness and implementation among pediatric primary care providers of the 2012 American Heart Association (AHA) guidelines for the evaluation and management of developmental abnormalities in children with congenital heart disease (CHD). We hypothesized that children with CHD are not being provided neurodevelopmental screening and support according to the AHA guidelines.
Study Design:
An online survey was administered to licensed pediatric primary care providers in Minnesota (pediatricians = 530, family physicians = 1469) to evaluate awareness of the AHA guidelines, current screening practices, and barriers to implementation of these guidelines.
Results:
A total of 326 providers (17% of 1911 successful e-mails) responded to the survey, which included 148 pediatricians (29% of 518 successful e-mails) and 178 family physicians (13% of 1393 successful e-mails). Overall, 202 providers (62%) reported caring for children with CHD. Among those caring for children with CHD, the most commonly reported reasons for neurodevelopmental referral were nonspecific to CHD. Presence of risks specific to children with CHD, such as history of cyanotic heart disease or open heart surgery as an infant, accounted for only 25% and 22% of the referrals, respectively. Only 21% of providers were aware of the guidelines, and only 7% received guidance from a pediatric cardiologist regarding neurodevelopmental screening in children with CHD.
Conclusion:
There is need for further education of primary care providers on the developmental risks associated with CHD as well as increased involvement by the pediatric cardiology community to enhance the developmental outcomes of children with CHD.
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