Key Factors of Adherence in Cardiological Follow-Up of Adults with Congenital Heart Disease

Approximately 50% of adults with congenital heart defects (ACHD) lack specialised CHD care, increasing the risk of preventable complications and mortality. While there is evidence that psychological factors significantly influence adherence, predictors of attending cardiological routine examinations in ACHD remain understudied. This is the first German study to examine psychological and sociodemographic predictors of adherence in ACHD using the Common-Sense Model of Self-Regulation as a framework. A total of N = 1136 participants from the National Register for Congenital Heart Defects were analysed. Sociodemographic and psychological factors (illness perception, illness identity, emotion regulation and psychological distress) were recorded as predictors of the subjective importance of regular cardiological check-ups and the actual utilisation frequency. The results indicate that of the sociodemographic factors, only age is relevant for the subjective importance, while net income influences the actual utilisation of cardiological examinations. In contrast, several psychological aspects of illness perception, such as perceived treatment benefit, and illness identity play a role for both adherence measures, as do depressive symptoms for the frequency of examinations. Our results highlight the importance of addressing psychological factors and providing clear information about the benefits of cardiological care to improve adherence in ACHD and thereby reduce secondary diseases.