Primärversorgung von Erwachsenen mit angeborenen Herzfehlern

Seidel, Lavinia Sophia (2021): Primärversorgung von Erwachsenen mit angeborenen Herzfehlern: die Sicht der Ärzte. Dissertation, LMU München: Medizinische Fakultät

Abstract

Due to the increased survival rate of children with congenital heart disease (CHD) in the last decades, more than 90 percent of patients with CHD now reach adulthood. The causes of this increase are in particular the development of congenital heart surgery as well as advances in other medical sectors (e.g. intensive care, pharmacotherapy, and anesthesia) during the 20th century. As a result of this progress, there are currently more than 300.000 adults with congenital heart disease (ACHD) in Germany. Different clinical studies have demonstrated that this trend will continue and will lead to an increase in importance of ACHD. This is, however, not an isolated German phenomenon, but can be observed all over the world. Although the group of ACHD is very inhomogeneous, almost all ACHD have a chronic heart disease. Even if they receive optimal medical treatment they suffer under specific residual and follow conditions. In addition, cardiac and non-cardiac comorbidities play an important role regarding morbidity and mortality of these patients. Since 2005 there have been specific supply structures for ACHD in Germany to ensure optimal treatment for this special patient group. The aim is for ACHD patients to receive regular cardiac follow-up care provided by ACHD-specialized physicians in cooperation with primary practitioners to reduce mortality and morbidity. Until now, awareness of the importance and existence of supply structures for ACHD and their actual use has not yet been analyzed. The present VEmaH study is intended to show the actual real-life supply condition of ACHD from the primary care (general practitioners, general internists) perspective. N = 767 explorative questionnaires of medical practitioners in primary care were evaluated. Our study showed that only 23.9 % (n = 183) of the primary practitioners indicated a specialized ACHD physician as a co-treating physician and that 33.8 % (n = 259) did not know certified ACHD centers. Moreover, 52.5 % (n = 372) of the physicians noted that they were not sufficiently informed about existing supply structures. It can be concluded that the supply structure for ACHD is still not sufficiently known by physicians in primary care. Furthermore, the willingness of general practitioners to attend to the ACHD issue is inadequate and the significance of a deficient care of ACHD is underrated. The awareness for the ACHD issue must be increased especially under primary care practitioners because they build the base and the foundation for an ideal ACHD care.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: Angeborene Herzfehler, Primärversorgung, Erwachsene mit angeborenen Herzfehlern
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Deutsch
• Datum der mündlichen Prüfung: 16. Dezember 2021
• 1. Bericht­erstatter:in: Schelling, Jörg