Application of the PRISM Resilience Intervention in Adult Congenital Heart Disease (RP213)

Outcomes 1. Recognize the psychosocial challenges associated with adult congenital heart disease2. Discuss the potential use of a resilience-building intervention in this population Key Message Patients with adult congenital heart disease face impaired quality of life and psychological distress. Enhanced resilience can provide resources for better disease management. In this study, implementing a resilience-building intervention is feasible and participants viewed it favorably. However, remote recruitment was more challenging than anticipated. Importance Adult congenital heart disease (ACHD) is a life-long condition that often impairs quality of life and causes psychological distress. Promoting Resilience in Stress Management (PRISM), is a brief patient-focused intervention which has been proven to improve resilience in other disease populations. Objective(s) To determine the feasibility, acceptability, and preliminary efficacy of utilizing PRISM in ACHD. Scientific Methods Utilized We enrolled adult outpatients with moderate or complex ACHD, physiologic stages C/D, who were English-speaking, able to independently participate, and without another life-limiting condition. Beginning in March 2023, participants were randomly assigned to intervention versus usual care groups. We defined feasibility as 70% of eligible patients would enroll, and 70% completion of all sessions. Acceptability was defined qualitatively based on feedback regarding intervention content and delivery. Questionnaires evaluating self-reported resilience (Connor-Davidson Resilience Scale10) were completed at baseline and 3 months to determine preliminary efficacy. We secondarily explored quality of life (Euro-QOL 5D-3L and linear analog scale), psychological distress (Kessler-6, Hospital Anxiety and Depression Scale), self-competency (Perceived Competency Scale), and comfort with advance care planning. Results At 7 months into recruitment, 246 patients were invited and 49 enrolled (20%). This is 60% of anticipated enrollment. Median age was 37 years (range 19-60), 26 (53%) were female, 31 (63%) were non-Hispanic White. To date, 16 completed all sessions with generally positive feedback; 8 are in-progress. The stress management session was most liked; the advance care planning module was most divisively evaluated. Mean CD-RISC10 score increased 3.8±6.8 points for the usual care group, 1.5±8.2 for PRISM. Final results will be available by the time of the meeting. Conclusion(s) Among adult outpatients with ACHD, PRISM was feasible and acceptable once begun, however achieving enrollment was more difficult than anticipated. Impact This study provides insights to guide a future, large multisite randomized trial of PRISM in ACHD. Keywords Psychosocial support/Pain and symptom control