Canadian Journal of Cardiology



      Many adolescents living with heart disease face challenges when transitioning from pediatric to adult care. There is little evidence on how use of smartphone technology influences transition readiness. Just TRAC it! is a method of using existing features on a smartphone, including the Notes, Calendar, and Contacts apps, as a way for adolescents and adults to manage their health. We aimed to investigate the impact of nurse-led teaching with vs. without Just TRAC it! on self-management skills in this population.


      We conducted a randomized clinical trial of 16-18 year olds with congenital heart disease (CHD) or acquired heart disease requiring surgery. Participants were randomly allocated 1:1 to either usual care (control; 1-hour education session) or the smartphone intervention (1-hour education session including Just TRAC it!). The primary outcome was change in TRANSITION-Q score between baseline, 3 and 6 months. Secondary outcomes were frequency of use and perceived usefulness of Just TRAC it! at 3 and 6 months post intervention. Analysis was intention to treat. We enrolled 68 patients (41% female, mean age 17.3 years). Cardiac diagnosis was simple CHD (34%), moderate CHD (49%), complex CHD (13%), and acquired heart disease (4%). Sixty-eight percent had previous cardiac surgery and 26% had a previous cardiac catheterization. TRANSITION-Q scores were similar at baseline and increased over time in both groups (Figure) but were not significantly different between groups at 6 months. On average, TRANSITION-Q score at 6 months were 0.9 points higher than at 3 months (95% CI 0.1-1.7). Each additional point at the baseline score brought, on average, a 0.7 point increase in TRANSITION-Q score (95% CI 0.5-0.9) each at 3 months and at 6 months. Perceived usefulness of Just TRAC it! is summarized (Table). Ninety-seven percent of participants indicated they would recommend Just TRAC it! to others at 3 months and 100% at 6 months.


      Nurse-led transition teaching with vs. without Just TRAC it! improved transition readiness based on TRANSITION-Q scores over time, with no significant difference between groups. The majority of participants found Just TRAC it! useful, with the camera, calendar and notes apps reported as the most useful. Participants had a positive reception to Just TRAC it! and would recommend it to others. Longer follow-up is needed to assess how smartphone technology is used by young adults to facilitate their entry into the adult healthcare system.
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