Effects of transition programmes to adulthood for adolescents and young adults with CHD: a systematic review with meta-analysis

Abstract

Abstract Background: The increased survival rate among individuals with CHD has sparked interest in their transition to adult healthcare. Although there is a general agreement on the importance of transition interventions, the empirical evidence supporting them is insufficient. Therefore, this study aimed to conduct a systematic review and meta-analysis of transition interventions for adult healthcare in adolescents and young adults. Methods and results: A literature search was conducted for studies comparing the quantitative effects of transition interventions with control groups, published up to March 15, 2023, in major databases (CENTRAL, Embase, PubMed, Web of Science, CINAHL, KISS, and KMbase), major clinical trial registries, academic journal sites related to the topic, and grey literature databases. Ten studies involving a total of 1,297 participants were identified. Transition interventions proved effective in enhancing disease-related knowledge (Hedge’s g = 0.89, 95% CI = 0.29−1.48) and self-management (Hedge’s g = 0.67, 95% CI = 0.38−0.95), as well as reducing loss to follow-up (OR = 0.41, 95% CI = 0.22−0.77). The certainty of evidence for the estimated values of each major outcome was low or very low. Conclusions: This study supports the implementation of transition interventions by demonstrating that they can improve patients’ disease knowledge and self-management, while also promoting treatment continuity. However, since the available data on transition interventions for adolescents and young adults with CHD remain limited, the widespread adoption of structured transition interventions in the future may alter the conclusions of this study. Registration: URL: https://www.crd.york.ac.uk/PROSPERO. Unique identifier: CRD42023399026.