Key result
Review identifies 22 distinct neurodevelopmental follow-up pathways in CHD, highlighting multidisciplinary clinics and key barriers.
Why the study?
The study aimed to identify and map evidence describing components of neurodevelopmental follow-up care for children with congenital heart disease.
Systematic Review (n=3,132)
Structured neurodevelopmental follow-up care for children with congenital heart disease is highly variable and faces significant implementation barriers, highlighting the need for context-relevant adaptation of guidelines.
Answers are grounded in this paper and cite their sources.
Barriers limit neurodevelopmental follow-up in congenital heart disease; leaves open optimal standardized pathways for prospective trials.
AIM: To identify and map evidence describing components of neurodevelopmental follow-up care for children with congenital heart disease (CHD). METHOD: This was a scoping review of studies reporting components of neurodevelopmental follow-up programmes/pathways for children with CHD. Eligible publications were identified through database searches, citation tracking, and expert recommendations. Two independent reviewers screened studies and extracted data. An evidence matrix was developed to visualize common characteristics of care pathways. Qualitative content analysis identified implementation barriers and enablers. RESULTS: The review included 33 studies. Twenty-one described individual care pathways across the USA (n = 14), Canada (n = 4), Australia (n = 2), and France (n = 1). The remainder reported surveys of clinical practice across multiple geographical regions. While heterogeneity in care existed across studies, common attributes included enrolment of children at high-risk of neurodevelopmental delay; centralized clinics in children's hospitals; referral before discharge; periodic follow-up at fixed ages; standardized developmental assessment; and involvement of multidisciplinary teams. Implementation barriers included service cost/resourcing, patient burden, and lack of knowledge/awareness. Multi-level stakeholder engagement and integration with other services were key drivers of success. INTERPRETATION: Defining components of effective neurodevelopmental follow-up programmes and care pathways, along with enhancing and expanding guideline-based care across regions and into new contexts, should continue to be priorities. WHAT THIS PAPER ADDS: Twenty-two different neurodevelopmental follow-up care pathways/programmes were published, originating from four countries. Twelve additional publications described broad practices for neurodevelopmental follow-up across regions Common attributes across eligibility, service structure, assessment processes, and care providers were noted. Studies reported programme acceptability, uptake, cost, and effectiveness. Implementation barriers included service cost/resourcing, patient burden, and lack of knowledge/awareness.
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Abell et al. (2023) conducted a systematic review in congenital heart disease (n=3,132). Neurodevelopmental follow-up care pathways was evaluated on Components of neurodevelopmental follow-up care pathways. A scoping review of 33 studies identified 22 different neurodevelopmental follow-up care pathways for children with congenital heart disease, highlighting common attributes like centralized clinics and multidisciplinary teams, alongside implementation barriers such as cost and patient burden.
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