The role of primary care in childhood heart disease: A scoping review

This scoping review identified responsibilities of physicians in primary care provision to children with heart disease using the Arksey and O’Malley Framework. Original peer-reviewed research focused on experiences, perceptions, or roles of primary care physicians in caring for children with heart disease was included. Five bibliographic databases were searched (MEDLINE, Cumulative Index of Nursing and Allied Health Literature, Embase, PsychInfo, and Scopus). Google Scholar was used for citation tracking and grey literature searches. Two independent reviewers screened studies and extracted data. 20 studies were included, representing heterogenous patient cohorts ( n = 13, 65%), primary care physicians ( n = 6, 30%), paediatricians ( n = 6, 30%), and specialists ( n = 4, 20%). Three themes existed: primary care physician role and preferences in care ( n = 6, 30%); primary care access ( n = 8, 40%); and preventative and holistic healthcare measures ( n = 7, 35%). Barriers to care delivery included lack of confidence in physician knowledge; lack of time and financial incentive to reduce knowledge gaps; lack of clear responsibilities; and ineffective stakeholder communication. Enablers included knowledge of family and longevity in the family’s care. Findings highlighted important roles, and barriers to delivery, of primary care in this patient group. Investigation of health systems, communication, education, and funding to support primary care participation remains a priority.