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Clinical and socio-economic predictors of work participation in adult CHD patients

Published online by Cambridge University Press:  02 July 2020

Lauren A. Sarno*
Affiliation:
Department of Pediatrics, Pediatric Cardiology, Brody School of Medicine at East Carolina University, Greenville, NC, USA
Lindsay Cortright
Affiliation:
Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
Tiara Stanley
Affiliation:
Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
Dmitry Tumin
Affiliation:
Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
Jennifer S. Li
Affiliation:
Department of Pediatrics, Pediatric Cardiology, Duke University School of Medicine, Durham, NC, USA
Charlie J. Sang Jr
Affiliation:
Department of Pediatrics, Pediatric Cardiology, Brody School of Medicine at East Carolina University, Greenville, NC, USA
*
Author for correspondence: Lauren A. Sarno, MD, Department of Pediatrics, Pediatric Cardiology, Brody School of Medicine, East Carolina University, 115 Heart Drive, Greenville, NC27834-4354, USA. Tel. +1 252-744-5601; Fax: +1 252-744-3814. E-mail: [email protected]

Abstract

Background:

Adults with CHD have reduced work participation rates compared to adults without CHD. We aimed to quantify employment rate among adult CHD patients in a population-based registry and to describe factors and barriers associated with work participation.

Methods:

We retrospectively identified adults with employment information in the North Carolina Congenital Heart Defects Surveillance Network. Employment was defined as any paid work in a given year. Logistic regression was used to examine patients’ employment status during each year.

Results:

The registry included 1,208 adult CHD patients with a health care encounter between 2009 and 2013, of whom 1,078 had ≥1 year of data with known employment status. Overall, 401 patients (37%) were employed in their most recent registry year. On multivariable analysis, the odds of employment decreased with older age and were lower for Black as compared to White patients (odds ratio = 0.78; 95% confidence interval: 0.62, 0.98; p = 0.030), and single as compared to married patients (odds ratio = 0.50; 95% confidence interval: 0.39, 0.63; p < 0.001).

Conclusion:

In a registry where employment status was routinely captured, only 37% of adult CHD patients aged 18–64 years were employed, with older patients, Black patients, and single patients being less likely to be employed. Further work is needed to consider how enhancing cardiology follow-up for adults with CHD can integrate support for employment.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Weale, J, Kelleher, AA.Adult congenital heart disease. J Anesth Intensive Care Med 2018;19:285291.10.1016/j.mpaic.2018.03.013CrossRefGoogle Scholar
Gleason, LP, Deng, LX, Khan, AMet al.Psychological distress in adults with congenital heart disease: focus beyond depression. Cardiol Young 2018;29:185189.CrossRefGoogle Scholar
Sluman, MA, Apers, S, Sluiter, JKet al.Education as important predictor for successful employment in adults with congenital heart disease worldwide. Congenit Heart Dis 2019;14:362371.10.1111/chd.12747CrossRefGoogle ScholarPubMed
Kamphuis, M, Vogels, T, Ottenkamp, J, van der Wall, EE, Verloove-Vanhorick, SP, Vliegen, HW.Employment in adults with congenital heart disease. Arch Pediatr Adolesc Med 2002;156:11431148.10.1001/archpedi.156.11.1143CrossRefGoogle ScholarPubMed
Pickup, L, Gaffey, T, Clift, P, Bowater, S, Thorne, S, Hudsmith, L.Employment characteristics of a complex adult congenital heart disease cohort. Occup Med 2017;67:453455.10.1093/occmed/kqx085CrossRefGoogle ScholarPubMed
Crossland, DS, Jackson, SP, Lyall, R, Burn, J, Sullivan, JJ.Employment and advice regarding careers for adults with congenital heart disease. Cardiol Young 2005;15:391395.CrossRefGoogle ScholarPubMed
Agarwal, A, Thombley, R, Broberg, CSet al.Age- and lesion-related comorbidity burden among US adults with congenital heart disease: a population-based study. J Am Heart Assoc 2019;8:e013450.CrossRefGoogle ScholarPubMed
Tumin, D, Chou, H, Hayes, D Jr, Tobias, JD, Galantowicz, M, McConnell, PI.Employment after heart transplantation among adults with congenital heart disease. Congenit Heart Dis 2017;12:794799.CrossRefGoogle ScholarPubMed
Eslami, B, Kovacs, AH, Moons, P, Abbasi, K, Jackson, JL.Hopelessness among adults with congenital heart disease: cause for despair or hope? Int J Cardiol 2017;230:6469.10.1016/j.ijcard.2016.12.090CrossRefGoogle ScholarPubMed
Pfitzer, C, Helm, PC, Rosenthal, LMet al.Educational level and employment status in adults with congenital heart disease. Cardiol Young 2018;28:3238.10.1017/S104795111700138XCrossRefGoogle ScholarPubMed
Helm, PC, Sticker, EJ, Keuchen, Ret al.IS having a job a protective factor? Employment status and state of medical care as subjectively perceived by adults with CHD in Germany. Cardiol Young 2017;27:11101117.10.1017/S1047951116002146CrossRefGoogle Scholar
Zomer, AC, Vaartjes, I, Uiterwaal, CSPet al.Social burden and lifestyle in adults with congenital heart disease. Am J Cardiol 2012;109:16571669.10.1016/j.amjcard.2012.01.397CrossRefGoogle ScholarPubMed
Ochiai, R, Ikeda, Y, Kato, H, Shiraishi, I, Parents’ Association of Heart Disease Children. Social independence of adult congenital heart disease patients in Japan. Pediatr Int 2017;59:675681.10.1111/ped.13260CrossRefGoogle ScholarPubMed
Karsenty, C, Maury, P, Blot-Souletie, Net al.The medical history of adults with complex congenital heart disease affects their social development and professional activity. Arch Cardiovasc Dis 2015;108:589597.CrossRefGoogle ScholarPubMed
Geyer, S, Norozi, K, Buchhorn, R, Wessel, A.Chances of employment in women and men after surgery of congenital heart disease: comparisons between patients and the general population. Congenit Heart Dis 2009;4:2533.10.1111/j.1747-0803.2008.00239.xCrossRefGoogle ScholarPubMed
Razzaghi, H, Oster, M, Reefhuis, J.Long-term outcomes in children with congenital heart disease: National Health Interview Survey. J Pediatr 2015;166:119124.CrossRefGoogle ScholarPubMed
Opotowsky, AR, Siddiqi, OK.Trends in hospitalizations for adults with congenital heart disease in the US. J Am Coll Cardiol 2009;54:460467.10.1016/j.jacc.2009.04.037CrossRefGoogle Scholar
Warnes, CA, Liberthson, R, Danielson, GKet al.Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol 2001;37:11611698.10.1016/S0735-1097(01)01272-4CrossRefGoogle ScholarPubMed
Saczynski, JS, Andrade, SE, Harrold, LRet al.A systematic review of validated methods for identifying heart failure using administrative data. Pharmacoepidemiol Drug Saf 2012;21 Suppl 1:129140.CrossRefGoogle ScholarPubMed
Sherzai, D, Losey, T, Vega, S, Sherzai, A.Seizures and dementia in the elderly: Nationwide inpatient sample 1999–2008. Epilepsy Behav 2014;36:5356.10.1016/j.yebeh.2014.04.015CrossRefGoogle ScholarPubMed
Nyboe, C, Fonager, K, Larsen, ML, Andreasen, JJ, Lundbye-Christensen, S, Hjortdal, V.Effect of atrial septal defect in adults on work participation (from a nation wide register-based follow-up study regarding work participation and use of permanent social security benefits). Am J Cardiol, 2019 September 9. [Epub ahead of print].CrossRefGoogle Scholar
Tumin, D.Marriage trends among Americans with childhood-onset disabilities, 1997–2013. Disabil Health J 2016;9:713718.10.1016/j.dhjo.2016.05.004CrossRefGoogle ScholarPubMed
Warnes, CA, Williams, RG, Bashore, TMet al.ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the management of adults with congenital heart disease). Circulation 2008;118:e714e833.Google Scholar
Robbins, JM, Onukwube, J, Goudie, A, Collins, RT.How often is congenital heart disease recognized as a significant comorbidity among hospitalized adults with congenital heart disease? Int J Cardiol 2017;235:4248.10.1016/j.ijcard.2017.02.100CrossRefGoogle ScholarPubMed
Steiner, JM, Kirkpatrick, JN, Heckbert, SRet al.Identification of adults with congenital heart disease of moderate or great complexity from administrative data. Congenit Heart Dis 2018;13:6571.CrossRefGoogle ScholarPubMed
Moons, P, Kovacs, AH, Luyckx, K, Thomet, Cet al.APPROACH-IS consortium and the International Society for Adult Congenital Heart Disease (ISACHD). Patient-reported outcomes in adults with congenital heart disease: Inter-country variation, standard of living and healthcare system factors. Int J Cardiol 2018;251:3441.CrossRefGoogle ScholarPubMed