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Health-care transition after Kawasaki disease in patients with coronary artery lesion
Hiroshi Kamiyama1,2, Mamoru Ayusawa1, Shunichi Ogawa3
1Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi, Japan.
Insights
Health-care transition for adults with childhood coronary artery lesions (CAL) after Kawasaki disease (KD) faces challenges. Over 40% experienced loss to follow-up, highlighting the need for improved pediatrician-cardiologist collaboration.
Area of Science:
- Cardiology
- Pediatrics
- Health Services Research
Background:
- Kawasaki disease (KD) can cause coronary artery lesions (CAL) in children.
- Successful health-care transition (HCT) is crucial for adults with childhood CAL.
- Understanding HCT realities and loss to follow-up is essential for patient outcomes.
Purpose of the Study:
- To investigate the current state of HCT for adults with a history of CAL post-KD.
- To identify the extent of loss to follow-up during the HCT process.
Main Methods:
- A nationwide online questionnaire survey was conducted among members of the Japanese Society of Kawasaki Disease.
- Data were collected from May to July 2014, with a response rate of 83.3%.
Main Results:
- Over 90% of respondents manage patients requiring HCT, with 55% having completed HCT for some patients.
- More than 40% of respondents reported loss to follow-up in HCT.
- Most respondents viewed HCT care provided by cardiologists favorably and supported continued pediatrician-cardiologist information sharing.
Conclusions:
- Adult cardiologists are increasingly managing patients with CAL post-KD.
- Pediatricians should develop support programs and collaborate with cardiologists to improve HCT and reduce loss to follow-up.
Background:
Discussion of health-care transition (HCT) for adults with a childhood history of coronary artery lesions (CAL) after Kawasaki disease (KD) is important. A nationwide questionnaire survey was performed with support by the Japanese Society of Kawasaki Disease. The purpose of this study was to clarify the reality of HCT and loss to follow-up in patients with CAL after KD.
Methods:
The survey was emailed to 48 members of the Japanese Society of Kawasaki Disease from May to July 2014.
Results:
Forty surveys were collected, giving a response rate of 83.3%. Sixty-five percent of the respondents belonged to a university hospital. Approximately 90% of the respondents dealt with patients who needed HCT, and 55% had patients who completed HCT. Approximately 70% of the respondents considered that pediatricians should continue sharing HCT information with cardiologists. More than 95% of the respondents had a favorable or average impression of HCT care provided by cardiologists. The percentage of respondents who had loss to follow up for HCT was >40%.
Conclusion:
Adult cardiologists began managing patients with CAL after KD in more than half of the institutes in this study. Pediatricians should construct a support program for better management of these patients and for cooperation with cardiologists to prevent loss to follow up.
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