Red Flags for Maltese Adults with Congenital Heart Disease: Poorer Dental Care and Less Sports Participation Compared to Other European Patients-An APPROACH-IS Substudy.
Studies in recent years have explored lifestyle habits and health-risk behaviours in adult congenital heart disease (ACHD) patients when compared to controls. The aim of this study was to investigate differences in lifestyle habits between Maltese and other European ACHD patients. Data on alcohol consumption, cigarette smoking, substance misuse, dental care and physical activity collected in 2013-2015 during "Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease-International Study" (APPROACH-IS) were analysed. Responses from 119 Maltese participants were compared to those of 1616 participants from Belgium, France, Italy, Norway, Sweden, Switzerland and the Netherlands. Significantly fewer Maltese patients with simple (Maltese 84.1% vs. European 97.5%, p < 0.001) and moderately complex CHD (Maltese 83.6% vs. European 97.4%, p < 0.001) brushed their teeth daily. Only 67.2% of Maltese with moderately complex disease had dental reviews in the previous year compared to 80.3% of Europeans (p = 0.02). Maltese patients with simple (Maltese 31.8% vs. European 56.1%, p = 0.002) and moderately complex lesions (Maltese 30.0% vs. European 59.2%, p < 0.001) performed less regular sport activities. Comparison by country showed Maltese patients to have significantly poorer tooth brushing and sports participation than patients from any other participating country. Alcohol consumption, cigarette smoking and substance misuse were not significantly different. This study highlights lifestyle aspects that Maltese ACHD patients need to improve on, which might not be evident upon comparing patients to non-CHD controls. These findings should also caution researchers against considering behaviours among patients in one country as necessarily representative of patients on the larger scale.
Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Msida, MSD 2090, Malta. caruana.maryanne@gmail.com.
Maryanne
http://orcid.org/0000-0003-3947-3350
M
Caruana
Department of Public Health and Primary Care, KU Leuven - University of Leuven, 3000, Leuven, Belgium.|Department of Development and Regeneration, KU Leuven - University of Leuven, 3000, Leuven, Belgium.
Silke
S
Apers
Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA.
Adrienne H
AH
Kovacs
School Psychology and Child and Adolescent Development, KU Leuven - University of Leuven, 3000, Leuven, Belgium.
Koen
K
Luyckx
Center for Congenital Heart Disease, University Hospital Bern, Bern, Switzerland.
Corina
C
Thomet
Division of Congenital and Structural Cardiology, University Hospitals Leuven, KU Leuven - University of Leuven, 3000, Leuven, Belgium.
Werner
W
Budts
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
Maayke
M
Sluman
Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Katrine
K
Eriksen
Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.|Adult congenital heart unit, Sahlgrenska University Hospital/Östra and Institute for Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Mikael
M
Dellborg
Department of Health Science, University West, Trollhättan, Sweden.|Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
Malin
M
Berghammer
Department of Clinical Medicine and Public Health, Umeå University, Umeå, Sweden.
Bengt
B
Johansson
Hospital Louis Pradel, Lyon, France.
Alexandra
A
Soufi
Clinical Psychology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
Edward
E
Callus
Department of Public Health and Primary Care, KU Leuven - University of Leuven, 3000, Leuven, Belgium.|Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Philip
P
Moons
Department of Paediatrics, University of Malta Medical School, MSD 2090, Msida, Malta.
Victor
V
Grech
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D003729:Dental Care / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006801:Humans; D008019:Life Style; D008297:Male; D008319:Malta / Q000453:epidemiology; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology; D013177:Sports / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
Congenital heart disease; Health behaviour; Lifestyle; Risk factors