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Paediatric cardiologist adherence to American Heart Association neurodevelopmental recommendations for CHD patients
Sharnendra K Sidhu1, Laura J McLaughlin1, Tammy B Pham1
1Division of Developmental & Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, NY, USA.
Insights
Pediatric cardiologists often lack awareness of American Heart Association guidelines for children with congenital heart disease (CHD), leading to inconsistent developmental screening and referrals. Collaboration is crucial to improve neurodevelopmental care for these at-risk children.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Pediatrics
- Public Health
Background:
- Children with congenital heart disease (CHD) face increased risks for neurodevelopmental delays.
- American Heart Association (AHA) guidelines recommend routine surveillance and evaluation for these children.
- Paediatric cardiologist adherence to these guidelines and referral practices requires assessment.
Purpose of the Study:
- To evaluate paediatric cardiologist awareness and implementation of AHA guidelines for neurodevelopmental surveillance in CHD patients.
- To assess current referral practices for developmental evaluations among paediatric cardiologists nationwide.
Main Methods:
- A nationwide survey was distributed to 129 paediatric cardiologists.
- The survey assessed familiarity with AHA statements, institutional programs, and referral/surveillance practices.
- Investigated cardiologists' perceived responsibility for developmental surveillance and referrals.
Main Results:
- A significant majority (69%) of paediatric cardiologists were unfamiliar with the 2012 AHA statement.
- 31% reported their institutions lacked dedicated neurodevelopmental cardiology programs.
- Varied referral practices were observed, with many not referring patients or only referring if warranted; 43% felt no responsibility for developmental surveillance.
Conclusions:
- Lack of awareness and perceived responsibility among paediatric cardiologists hinder adherence to developmental surveillance guidelines for CHD patients.
- Inconsistent screening and referral practices necessitate improved collaboration between paediatricians and cardiologists.
- Enhanced communication and shared accountability are vital to ensure timely neurodevelopmental evaluations for children with CHD.
Abstract:
A 2012 American Heart Association statement concluded that children with CHD are at an increased risk for neurodevelopmental delays. Routine surveillance and evaluation throughout childhood are recommended. To assess paediatric cardiologist compliance with American Heart Association guidelines and developmental referral practices, a survey was distributed to paediatric cardiologists nationwide (n = 129). The majority of participants (69%) stated they were somewhat familiar or not familiar with the American Heart Association statement and were concerned about patients not being properly referred to specialists for developmental evaluation. Forty paediatric cardiologists (31%) indicated that their institution did not have a neurodevelopmental cardiology programme. Of these, 25% indicated they generally did not refer CHD patients for neurodevelopmental evaluation, 45% performed surveillance and referred if warranted, and 30% generally referred all patients for surveillance. Lastly, 43% of paediatric cardiologists did not feel responsible for developmental surveillance, and 11% did not feel responsible for referrals. To ensure all children with CHD are appropriately screened and referred, paediatricians and cardiologists must work together to address differing impressions of accountability for surveillance and screening of children with CHD.
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