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Adolescents with congenital heart defects: a patient and parental perspective of genetic information and genetic risk

Published online by Cambridge University Press:  27 January 2020

Christopher A. Crawford
Affiliation:
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
Courtney E. Vujakovich
Affiliation:
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
Lindsey Elmore
Affiliation:
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
Emily Fleming
Affiliation:
Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA Division of Clinical Genetics, Children’s Mercy Kansas City, Kansas City, MO, USA
Benjamin J. Landis
Affiliation:
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
Katie G. Spoonamore
Affiliation:
Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
Stephanie M. Ware*
Affiliation:
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
*
Author for correspondence: S. M. Ware, Department of Pediatrics, Indiana University School of Medicine, 1044 W. Walnut Street, Indianapolis, IN 46202, USA. Tel: +1 317-274-8938; Fax: +1 317-274-8679; E-mail: [email protected]

Abstract

Congenital heart defects (CHDs) occur in 8 of 1000 live-born children, making them common birth defects in the adolescent population. CHDs may have single gene, chromosomal, or multifactorial causes. Despite evidence that patients with CHD want information on heritability and genetics, no studies have investigated the interest or knowledge base in the adolescent population. This information is necessary as patients in adolescence take greater ownership of their health care and discuss reproductive risks with their physicians. The objectives of this survey-based study were to determine adolescents’ recall of their own heart condition, to assess patient and parent perception of the genetic contribution to the adolescent’s CHD, and to obtain information about the preferred method(s) for education. The results show that adolescent patients had good recall of their type of CHD. Less than half of adolescents and parents believed their CHD had a genetic basis or was heritable; however, adolescents with a positive family history of CHD were more likely to believe that their condition was genetic (p = 0.0005). The majority of patients were interested in receiving additional genetics education and preferred education in-person and in consultation with both parents and a physician. The adolescents who felt most competent to have discussions with their doctors regarding potential causes of their heart defect previously had a school science course which covered topics in genetics. These results provide insight into adolescents’ perceptions and understanding about their CHD and genetic risk and may inform the creation and provision of additional genetic education.

Type
Original Article
Copyright
© Cambridge University Press 2020

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References

Dolk, H, Loane, M, Garne, E. Congenital heart defects in Europe: prevalence and perinatal mortality, 2000 to 2005. Circulation 2011; 123: 841849. doi: 10.1161/CIRCULATIONAHA.110.958405.CrossRefGoogle ScholarPubMed
Blue, GM, Kasparian, NA, Sholler, GF, Kirk, EP, Winlaw, DS. Genetic counselling in parents of children with congenital heart disease significantly improves knowledge about causation and enhances psychosocial functioning. Int J Cardiol 2015; 178: 124130. doi: 10.1016/j.ijcard.2014.10.119.CrossRefGoogle ScholarPubMed
Blue, GM, Kirk, EP, Sholler, GF, Harvey, RP, Winlaw, DS. Congenital heart disease: current knowledge about causes and inheritance. Med J Aust 2012; 197: 155159.10.5694/mja12.10811CrossRefGoogle ScholarPubMed
Cowan, JR, Ware, SM. Genetics and genetic testing in congenital heart disease. Clin Perinatol 2015; 42: 373393.10.1016/j.clp.2015.02.009CrossRefGoogle ScholarPubMed
Øyen, N, Poulsen, G, Boyd, HA, Wohlfahrt, J, Jensen, PKA, Melbye, M. Recurrence of congenital heart defects in families. Circulation 2009; 120: 295301. https://doi.org/10.1161/CIRCULATIONAHA.109.857987.CrossRefGoogle ScholarPubMed
van Engelen, K, Baars, MJH, van Rongen, LT, van der Velde, ET, Mulder, BJM, Smets, EMA. Adults with congenital heart disease: patients’ knowledge and concerns about inheritance. Am J Med Genet Part A 2011; 155A: 16611667. doi: 10.1002/ajmg.a.34068.CrossRefGoogle ScholarPubMed
Veldtman, GR, Matley, SL, Kendall, L, et al.Illness understanding in children and adolescents with heart disease. Heart (British Cardiac Society) 2000; 84: 395397.10.1136/heart.84.4.395CrossRefGoogle ScholarPubMed
Van Deyk, K, Pelgrims, E, Troost, E, et al.Adolescents’ understanding of their congenital heart disease on transfer to adult-focused care. Am J Cardiol 2010; 106: 18031807. doi: 10.1016/j.amjcard.2010.08.020.CrossRefGoogle ScholarPubMed
Le Lesch, W, Specht, K, Lux, A, Frey, M, Utens, E, Bauer, U. Disease-specific knowledge and information preferences of young patients with congenital heart disease. Cardiol Young 2014; 24: 321330. doi: 10.1017/S1047951113000413.CrossRefGoogle Scholar
Jackson, JL, Tierney, K, Daniels, CJ, Vannatta, K. Disease knowledge, perceived risk, and health behavior engagement among adolescents and adults with congenital heart disease. Heart Lung: J Crit Care 2015; 44: 3944. doi: 10.1016/j.hrtlng.2014.08.009.CrossRefGoogle ScholarPubMed
van Engelen, K, Baars, MJH, Felix, JP, Postma, AV, Mulder, BJM, Smets, EMA. The value of the clinical geneticist caring for adults with congenital heart disease: diagnostic yield and patients’ perspective. Am J Med Genet Part A 2013; 161A: 16281637. doi: 10.1002/ajmg.a.35973.CrossRefGoogle ScholarPubMed
Londono-Obregon, C, Goldmuntz, E, Davey, BT, Zhang, X, Slap, GB, Kim, YY. Adult CHD: the ongoing need for physician counselling about heredity and contraceptive options. Cardiol Young 2017; 27: 671676. doi: 10.1017/S1047951116001013.CrossRefGoogle ScholarPubMed
Smith, LA, Williams, JM.“It’s the X and Y Thing”: cross-sectional and longitudinal changes in children’s understanding of genes. Res Sci Educ 2007; 37: 407422. doi: 10.1007/s11165-006-9033-6.CrossRefGoogle Scholar
Kung, JT, Gelbart, ME. Getting a head start: the importance of personal genetics education in high schools. Yale J Biol Med 2012; 85: 8792.Google ScholarPubMed
McGill, BC, Wakefield, CE, Vetsch, J, et al.Children and young people’s understanding of inherited conditions and their attitudes towards genetic testing: a systematic review. Clin Genet 2019; 95: 1022. doi: 10.1111/cge.13253.CrossRefGoogle Scholar
Fanos, JH. Developmental tasks of childhood and adolescence: implications for genetic testing. Am J Med Genet 1997; 71: 2228.10.1002/(SICI)1096-8628(19970711)71:1<22::AID-AJMG4>3.0.CO;2-S3.0.CO;2-S>CrossRefGoogle ScholarPubMed
Hein, I, Troost, P, Lindeboom, R, et al.Feasibility of an assessment tool for children’s competence to consent to predictive genetic testing: a pilot study. J Genet Couns 2015; 24: 971977. doi: 10.1007/s10897-015-9835-7.CrossRefGoogle ScholarPubMed
Hufnagel, SB, Martin, LJ, Cassedy, A, Hopkin, RJ, Antommaria, AHM. Adolescents’ preferences regarding disclosure of incidental findings in genomic sequencing that are not medically actionable in childhood. Am J Med Genet Part A 2016; 170: 20832088. doi: 10.1002/ajmg.a.37730.CrossRefGoogle Scholar
McGowan, ML, Prows, CA, DeJonckheere, M, Brinkman, WB, Vaughn, L, Myers, MF. Adolescent and parental attitudes about return of genomic research results: focus group findings regarding decisional preferences. J Empirical Res Human Res Ethics 2018; 13: 371382. doi: 10.1177/1556264618776613.CrossRefGoogle ScholarPubMed
Moons, P, de Voider, E, Budts, W, et al.What do adult patients with congenital heart disease know about their disease, treatment, and prevention of complications? A call for structured patient education. Heart 2001; 86: 7480. doi: 10.1136/heart.86.1.74.CrossRefGoogle Scholar
Harris, PA, Taylor, R, Thielke, R, et al.Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inf 2009; 42: 377381. doi: 10.1016/j.jbi.2008.08.010.CrossRefGoogle ScholarPubMed
Birta, L, Emery, JD, Prevost, AT, Sutton, S, Walter, FM. Psychological impact of family history risk assessment in primary care: a mixed methods study. Family Pract 2014; 31: 409418. doi: 10.1093/fampra/cmu012.CrossRefGoogle Scholar
Beeri, M, Haramati, Z, Rein, JJ, Nir, A. Parental knowledge and views of pediatric congenital heart disease. Isr Med Assoc J: IMAJ 2001; 3: 194197.Google ScholarPubMed
Harding, B, Egan, R, Kannu, P, MacKenzie, J. Parents’ understanding of genetics and heritability. J Genet Counseling 2017; 26: 541547. doi: 10.1007/s10897-016-0021-3.CrossRefGoogle ScholarPubMed
Knauth Meadows, A, Bosco, V, Tong, E, Fernandes, S, Saidi, A. Transition and transfer from pediatric to adult care of young adults with complex congenital heart disease. Curr Cardiol Rep 2009; 11: 291297.10.1007/s11886-009-0042-8CrossRefGoogle ScholarPubMed
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