Prescription of cardiovascular medication in children with congenital heart defects across six European Regions from 2000 to 2014: data from the EUROlinkCAT population-based cohort study
Susan Jordan,
Maria Loane,
Anna Pierini,
Joan K Morris,
Clara Cavero-Carbonell,
Amanda J Neville,
Ester Garne,
Anna Heino,
Alessio Coi,
Aurora Puccini,
Joachim Tan,
Joanne Emma Given,
Gillian Briggs,
Stine Kjaer Urhoj,
Mads Damkjær,
Sonja Kiuru-Kuhlefelt,
Ieuan Scanlon,
Laia Barrachina-Bonet
Affiliations
Susan Jordan
Department of Nursing, Swansea University, Swansea, UK
Maria Loane
Institute of Nursing and Health Research, Faculty of Life and Health Sciences,Ulster University, Belfast, UK
Anna Pierini
Institute of Clinical Physiology National Research Council, Pisa, Italy
Joan K Morris
Population Health Research Institute, St George`s University of London, London, UK
Clara Cavero-Carbonell
Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian region, Valencia, Spain
Amanda J Neville
Registro IMER, University of Ferrara, Ferrara, Emilia-Romagna, Italy
Ester Garne
Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
Anna Heino
Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland
Alessio Coi
Institute of Clinical Physiology, National Research Council Pisa Research Area, Pisa, Italy
Aurora Puccini
Drug and Medical Device Area, Emilia Romagna Health Department, Emilia-Romagna Regional Healthcare Services, Bologna, Emilia-Romagna, Italy
Joachim Tan
Population Health Research Institute, St George`s University of London, London, UK
Joanne Emma Given
Institute of Nursing and Health Research, Faculty of Life and Health Sciences,Ulster University, Belfast, UK
Gillian Briggs
Population Health Research Institute, St George`s University of London, London, UK
Stine Kjaer Urhoj
associate professor
Mads Damkjær
Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital - University Hospital of Southern Denmark, Kolding, Denmark
Sonja Kiuru-Kuhlefelt
Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
Ieuan Scanlon
Department of Nursing, Swansea University, Swansea, UK
Laia Barrachina-Bonet
Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian region, Valencia, Spain
Objectives Advances in surgical management strategies have substantially reduced fatality from congenital heart defects (CHD). Decreased infant mortality might be expected, consequentially to result in greater morbidity in older children due to complications later in childhood and adolescence. This study aims to evaluate the use of cardiovascular medication (CVM) as an indicator of disease burden in children born with CHD in the first 10 years of life.Design Population-based cohort study.Setting Six population-based registries from the European Surveillance of Congenital Anomalies (EUROCAT) network participated. Data from live born children with major congenital anomalies (CA) born from 2000 to 2014 were linked to prescription databases. Four groups of children were analysed: CA, CHD, severe CHD (sCHD) and ventricular septal defect (VSD) without sCHD. Live born children without CA were included as reference group.Participants We obtained data on 61 038 children born with a CA, including 19 678 with CHD, 3392 with sCHD, 12 728 children with VSD without sCHD, and 1 725 496 reference children.Results Children born with sCHD were the most likely to receive a CVM prescription (42.9%, 95% CI, 26.3 to 58.5) in the first year of life compared with 13.3% (6.7 to 22.0) of children with any CHD, 5.9% (3.7 to 8.7) of children with any CA and 0.1% (0.0 to 0.1) of reference children. Medication was less likely to be prescribed after the first year of life for sCHD; 18.8% (14.8 to 23.1) for children 1–4 years and 15.8% (12.0 to 20.1) 5–9 years. Children with sCHD were most likely to receive a diuretic (36.4%, 18.6 to 54.5), an antihypertensive (6.9%, 3.7 to 11.3) or a beta-blocker (5.5%, 2.9 to9.2).Conclusion Almost half of all children with sCHD were prescribed CVM in their first year of life. For all four groups of children with anomalies, the proportion of children with a CVM prescription decreased with age.
