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Randomized Controlled Trial
. 2024 Aug;75(2):358-367.
doi: 10.1016/j.jadohealth.2024.04.022. Epub 2024 Jun 10.

Efficacy of a Transition Program in Adolescents and Young Adults With Congenital Heart Disease: The TRANSITION-CHD Randomized Controlled Trial

Charlene Bredy  1 , Oscar Werner  2 , Helena Huguet  3 , Sophie Guillaumont  2 , Annie Auer  4 , Anne Requirand  1 , Kathleen Lavastre  1 , Hamouda Abassi  1 , Gregoire De La Villeon  2 , Marie Vincenti  5 , Arthur Gavotto  6 , Remi Vincent  2 , Victor Pommier  2 , Yves Dulac  7 , Nathalie Souletie  7 , Philippe Acar  7 , Clement Karsenty  7 , Aitor Guitarte  7 , Marie Berge  8 , Gaelle Marguin  8 , Marie-Paule Masseron  9 , Laurence Pages  10 , Gerard Bourrel  11 , Agnes Oude Engberink  11 , Elodie Million  11 , Anne-Cecile Huby  12 , Bertrand Leobon  13 , Marie-Christine Picot  3 , Pascal Amedro  14
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Free article
Randomized Controlled Trial

Efficacy of a Transition Program in Adolescents and Young Adults With Congenital Heart Disease: The TRANSITION-CHD Randomized Controlled Trial

Charlene Bredy et al. J Adolesc Health. 2024 Aug.
Free article

Abstract

Purpose: Currently, nearly 90% of patients with congenital heart disease (CHD) reach adulthood in relatively good health. Structured transition programs have emerged to support adolescents and young adults in transitioning to adult care structures, improve their autonomy, and limit healthcare ruptures. The TRANSITION-CHD randomized controlled trial aimed to assess the impact of a transition program on health-related quality of life (HRQoL) in adolescents and young adults with CHD.

Methods: From January 2017 to February 2020, 200 subjects with a CHD, aged 13-25 years, were enrolled in a prospective, controlled, multicenter study and randomized in two balanced groups (transition program vs. standard of care). The primary outcome was the change in PedsQL self-reported HRQoL score between baseline and 12-month follow-up, using an intention-to-treat analysis. The secondary outcomes were the change in disease knowledge, physical health (cardiopulmonary fitness, physical activity), and mental health (anxiety, depression).

Results: The change in HRQoL differed significantly between the transition group and the control group (mean difference = 3.03, 95% confidence interval (CI) = [0.08; 5.98]; p = .044; effect size = 0.30), in favor of the intervention group. A significant increase was also observed in the self-reported psychosocial HRQoL (mean difference = 3.33, 95% CI = [0.01; 6.64]; p = .049; effect size = 0.29), in the proxy-reported physical HRQoL (mean difference = 9.18, 95% CI = [1.86; 16.51]; p = .015; effect size = 0.53), and in disease knowledge (mean difference = 3.13, 95% CI = [1.54; 4.72]; p < .001; effect size = 0.64).

Discussion: The TRANSITION-CHD program improved HRQoL and disease knowledge in adolescents and young adults with CHD, supporting the generalization and systematization of similar preventive interventions in pediatric and congenital cardiology.

Keywords: Behavior therapy; Congenital; Heart defects; Patient education; Preventive medicine; Quality of life.

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