Transitional Interventions and outcomes for Adolescents and Young Adults with Congenital Heart Disease: A Systematic Evidence Mapping of Randomized Controlled Trials

Abstract Background: With the advancement of medical technology, 85% of adolescent and young adult with congenital heart disease (CHD) can survive into adulthood. However, during their transition to the adult medical system, they face management gaps such as a high treatment interruption rate and increased psychosocial risks. Aims: To identify, describe and map the existing evidence on transitional care interventions for adolescents and young adults(AYAs) with CHD. Methods: PubMed, Web of Science, EMBASE, EBSCo, Cochrane Library, CBM, CNKI, Wang Fang, VIP Database, and article reference lists were searched for randomized controlled trials (RCTs) and systematic reviews (SRs) in February 2025. Study quality was evaluated using the Cochrane Handbook (Version 5.1.0) risk of bias tool. Evidence mapping (EM) visually represented research quality, outcomes, and sample sizes via the PyMeta website. Results: Eleven RCTs (1,075 patients, 45% female) met inclusion criteria. Intervention durations ranged from 1 hour to 24 weeks, with follow-up from 1 to 24 months. One low-quality, five medium-quality, and five high-quality RCTs were included from Canada (n=4), France (n=2), South Korea (n=1), Netherlands (n=2), Germany (n=1), and China (n=1). Studies focused on 10-25 year olds with moderate-to-severe CHD, assessing effectiveness by tracking disease knowledge, quality-of-life, and readiness for adult care. Conclusions Existing studies consistently support transition programs for enhancing disease knowledge, self-efficacy, and reducing follow-up losses. However, findings on exercise interventions' impact on quality of life are contradictory, and psychosocial intervention remains significantly understudied. Therefore, developing personalized interventions tailored to varying CHD severities, and tracking long-term effects, is essential.