Family Planning and Pregnancy Management in Adults with Congenital Heart Disease

Shum, Kelly; Gupta, Tripti; Canobbio, Mary M.; Durst, J; Shah, Sangeeta

doi:10.1016/j.pcad.2018.08.001

Cited by 12 publications

(8 citation statements)

References 67 publications

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“…Close pregnancy management is of utmost importance to limit health risks. 48 The higher hospitalization rate in females reflects the observed hospitalization patterns in the general population, even after exclusion of maternal stays. 49 Hence, pregnancy alone may not account for the differences in medical resource use.…”

Section: Discussionmentioning

confidence: 93%

Real-world healthcare utilization in adult congenital heart disease: a systematic review of trends and ratios

et al. 2019

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Background:As a result of medical advances, the adult congenital heart disease population is rapidly expanding. Nonetheless, most patients remain prone to increased morbidity and mortality. Therefore, long-term medical resource use is required. This systematic review aims to present the trends over the past decades of medical resource utilization in adult congenital heart disease as well as its current status, with a focus on hospitalizations, emergency department visits, outpatient cardiology visits, and visits to other healthcare professionals.Methods:MEDLINE (Pubmed), Embase, and Web of Science were searched for retrospective database research publications. The ISPOR checklist for retrospective database research was used for quality appraisal. Trends over time are explored.Results:Twenty-one articles met the inclusion criteria. All but one of the studies was conducted in Western Europe and North America. The absolute number of hospitalizations has been increasing over the last several decades. This increase is highest in patients with mild lesions, although these numbers are largely driven by hospitalizations of patients with an atrial septal defect or a patent foramen ovale. Meanwhile, outpatient cardiology visits are increasing at an even higher pace, and occur most often in geriatric patients and patients with severe lesions. Conversely, the number of hospitalizations per 100 patients is decreasing over time. Literature is scarce on other types of healthcare use.Conclusion:A strong rise in healthcare utilization is noticed, despite the mitigating effect of improved efficiency levels. As the population continues to grow, innovative medical management strategies will be required to accommodate its increasing healthcare utilization.

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Section: Discussionmentioning

confidence: 93%

Real-world healthcare utilization in adult congenital heart disease: a systematic review of trends and ratios

et al. 2019

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“…This study supported the thesis of higher medical costs in women although the cost per hospitalization was higher in men. Several explanations can be put forward to explain this disparity such as the impact of pregnancy management and -related hospitalization [32]. Previous research also suggested that, overall, women experience fewer barriers to making use of available healthcare services subsequently leading to a lower need for long-term inpatient care [33].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Healthcare Utilization, Medical Cost, and Societal Cost in Adult Congenital Heart Disease

Willems

Ombelet²,

Goossens³

et al. 2020

Congenital Heart Disease

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Objective: Cost-of-illness studies in Adult Congenital Heart Disease (ACHD) have mainly been limited to hospitalizations. This is the first paper to provide a comprehensive overview from a societal perspective including inpatient and outpatient medical costs, and absenteeism-and unemployment-related societal costs. Methods: A retrospective longitudinal (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) database analysis was performed in Belgium combining administrative and clinical databases (n = 10,572). Trends in resource use and costs per patient year were standardized to assess the impact of changes in the patient population composition. Generalized Linear Mixed Models assessed the impact of age, sex, lesion complexity, and time. Costs were converted to 2018 values. Results: Medical costs per patient year increased from V3490 to V4536 with a milder increase in patients with severe lesions. Although unemployment-related costs decreased, total societal costs increased due to more long-term (≥1 yr) invalidity. An increase in long-term invalidity was particularly found in patients ≥30 yrs and in patients with mild or moderate lesions. Resource use (e.g., dental care, nursing care, physiotherapy, emergency department) increased substantially in all patient groups over time. The annual percentage of patients with severe lesions receiving any cardiac and specialized cardiac follow-up increased with respectively 11 and 13 percent points to 81% and 52%, with a simultaneous decrease in hospitalization rate. Conclusion: Medical cost increases in ACHD are most pronounced in patients with mild and moderate lesions, relatable to their higher age. Economic data are necessary to allocate

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“…Another study also showed insufficient PCC in these women. [ 6 ] Given the necessity of PCC, especially in high-risk women,[ 14 23 24 ] these services should necessarily be provided for women with heart disease, especially by the reproductive health team. Another part of the results of study showed that there was also the lack of a safe and effective contraceptive method for preventing of unwanted pregnancy in these women.…”

Section: Discussionmentioning

confidence: 99%

“…These deficiencies have been also shown in other studies. [ 23 25 26 ] Given the high-risk pregnancy, especially unwanted pregnancies, in women with heart diseases, contraceptive method counseling is an important need of these women. [ 23 25 ] It is necessary to provide comprehensive reproductive health services to reduce the mortality and morbidity of these women.…”

Section: Discussionmentioning

confidence: 99%

Identifying and Responding to the Sexual Reproductive Health Needs of Women with Heart Disease

Kohan

Movahedi

Sadeghi

et al. 2022

Iranian Journal of Nursing and Midwifery Research

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Background: Recognizing the needs of women with heart disease in the field of reproductive health and meeting them can reduce the related complications. The aim of this study was to identify the sexual and reproductive health needs of these women. Materials and Methods: The present study was conducted with qualitative approach (Content analysis). Ten married women of reproductive age with heart disease and 20 providers and managers in, Isfahan, Iran, were selected by using purposive and snowball methods (in 2020). The research setting included heart disease clinics, offices of health team, comprehensive health centers, and the Isfahan Maternal Health Department. Data were collected by semi-structured individual face-to-face interviews in the clinic or other appropriate locations. Some interviews were conducted virtually. Analysis was performed by Qualitative contentment analysis / Conventional content analysis. Results: Sexual and reproductive health needs of women with heart disease were emerged in five main categories, “planned childbearing,” “ssociocultural support,” “Early reproductive health care of girls,” “health team attention to sexual health,” and “health system revision.” Conclusions: Providing comprehensive reproductive health services before and during pregnancy, family planning, and sexual health for women with heart disease is necessary. It seems that using a multidisciplinary team approach could improve their reproductive health.

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Family Planning and Pregnancy Management in Adults with Congenital Heart Disease

Cited by 12 publications

References 67 publications

Real-world healthcare utilization in adult congenital heart disease: a systematic review of trends and ratios

Real-world healthcare utilization in adult congenital heart disease: a systematic review of trends and ratios

Long-Term Healthcare Utilization, Medical Cost, and Societal Cost in Adult Congenital Heart Disease

Identifying and Responding to the Sexual Reproductive Health Needs of Women with Heart Disease

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