Publicação
Remote versus in-office monitoring for implantable cardioverter defibrillators: results from a randomized pragmatic controlled study in Portugal
| Resumo: | Introduction: Remote monitoring (RM) is a safe and effective alternative to in-office conventional follow-up. Objective: We aimed to evaluate patient satisfaction with RM and its impact on healthcare resources in a population with cardiac implantable electronic devices. Methods: Randomized, pragmatic, open-label controlled trial, with adult wearers of implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy with ICD (CRT-D), eligible for the CareLink® system. Patients newly implanted or with previous conventional follow-up were randomized to RM or conventional follow-up (control), and followed for 12 months, according to the centers' practice. The number of in-office visits and adverse events were compared between groups. Patient and healthcare professionals' satisfaction with RM were described. Results: Of the 134 randomized patients (69 RM; 65 control, aged 60±13 years), 80% were male, 23% employed, 72% ICD wearers and 54% newly implanted. Most patients (70%) reported travel costs less than 15€/visit, and 46% daily routine interference with in-office visits. Median physician/technician time with patient was 15 min/15 min, per in-office visit. Excluding baseline and final visits, control patients had more in-office visits in total: median 1 vs. 0, p<0.001. In 81% of the in-office visits, no clinical measures were taken. There were 10 adverse events, with no differences between groups. At the final visit, 95% of RM patients considered RM easy/very easy to use, and would all prefer to maintain RM and recommend it to others. All professionals found the CareLink website easy/very easy to use and were satisfied with transmission data. Conclusions: In a Portuguese population with ICD and CRT-D, RM safely reduced the burden of in-office visits, with high levels of satisfaction among patients and healthcare professionals. |
|---|---|
| Autores principais: | Oliveira, Mário |
| Outros Autores: | Fernandes, Milene; Reis, Hipólito; Primo, João; Sanfins, Victor; Silva, Vânia; Cunha, Pedro Silva; Silva, Mónica; Nicola, Paulo Jorge Morais Zamith |
| Assunto: | Implantable cardioverter-defibrillator Follow-up Remote monitoring |
| Ano: | 2022 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| _version_ | 1866810619957608448 |
|---|---|
| author | Oliveira, Mário |
| author2 | Fernandes, Milene Reis, Hipólito Primo, João Sanfins, Victor Silva, Vânia Cunha, Pedro Silva Silva, Mónica Nicola, Paulo Jorge Morais Zamith |
| author2_role | author author author author author author author author |
| author_facet | Oliveira, Mário Fernandes, Milene Reis, Hipólito Primo, João Sanfins, Victor Silva, Vânia Cunha, Pedro Silva Silva, Mónica Nicola, Paulo Jorge Morais Zamith |
| author_role | author |
| contributor_name_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Oliveira, Mário\"},{\"Person.name\":\"Fernandes, Milene\",\"Person.identifier.orcid\":\"0000-0002-6603-5092\"},{\"Person.name\":\"Reis, Hipólito\"},{\"Person.name\":\"Primo, João\"},{\"Person.name\":\"Sanfins, Victor\"},{\"Person.name\":\"Silva, Vânia\"},{\"Person.name\":\"Cunha, Pedro Silva\"},{\"Person.name\":\"Silva, Mónica\"},{\"Person.name\":\"Nicola, Paulo Jorge Morais Zamith\",\"Person.identifier.orcid\":\"0000-0003-0175-8457\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| datacite.creators.creator.creatorName.fl_str_mv | Oliveira, Mário Fernandes, Milene Reis, Hipólito Primo, João Sanfins, Victor Silva, Vânia Cunha, Pedro Silva Silva, Mónica Nicola, Paulo Jorge Morais Zamith |
| datacite.date.Accepted.fl_str_mv | 2022-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2022-12-16T15:50:07Z |
| datacite.date.embargoed.fl_str_mv | 2022-12-16T15:50:07Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Implantable cardioverter-defibrillator Follow-up Remote monitoring |
| datacite.titles.title.fl_str_mv | Remote versus in-office monitoring for implantable cardioverter defibrillators: results from a randomized pragmatic controlled study in Portugal Monitoração remota versus seguimento hospitalar presencial em portadores de cardioversor-desfibrilhador: resultados dum estudo randomizado em Portugal |
| dc.contributor.none.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| dc.creator.none.fl_str_mv | Oliveira, Mário Fernandes, Milene Reis, Hipólito Primo, João Sanfins, Victor Silva, Vânia Cunha, Pedro Silva Silva, Mónica Nicola, Paulo Jorge Morais Zamith |
| dc.date.Accepted.fl_str_mv | 2022-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2022-12-16T15:50:07Z |
| dc.date.embargoed.fl_str_mv | 2022-12-16T15:50:07Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10451/55431 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Elsevier |
| dc.rights.cclincense.fl_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Implantable cardioverter-defibrillator Follow-up Remote monitoring |
| dc.title.fl_str_mv | Remote versus in-office monitoring for implantable cardioverter defibrillators: results from a randomized pragmatic controlled study in Portugal Monitoração remota versus seguimento hospitalar presencial em portadores de cardioversor-desfibrilhador: resultados dum estudo randomizado em Portugal |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Introduction: Remote monitoring (RM) is a safe and effective alternative to in-office conventional follow-up. Objective: We aimed to evaluate patient satisfaction with RM and its impact on healthcare resources in a population with cardiac implantable electronic devices. Methods: Randomized, pragmatic, open-label controlled trial, with adult wearers of implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy with ICD (CRT-D), eligible for the CareLink® system. Patients newly implanted or with previous conventional follow-up were randomized to RM or conventional follow-up (control), and followed for 12 months, according to the centers' practice. The number of in-office visits and adverse events were compared between groups. Patient and healthcare professionals' satisfaction with RM were described. Results: Of the 134 randomized patients (69 RM; 65 control, aged 60±13 years), 80% were male, 23% employed, 72% ICD wearers and 54% newly implanted. Most patients (70%) reported travel costs less than 15€/visit, and 46% daily routine interference with in-office visits. Median physician/technician time with patient was 15 min/15 min, per in-office visit. Excluding baseline and final visits, control patients had more in-office visits in total: median 1 vs. 0, p<0.001. In 81% of the in-office visits, no clinical measures were taken. There were 10 adverse events, with no differences between groups. At the final visit, 95% of RM patients considered RM easy/very easy to use, and would all prefer to maintain RM and recommend it to others. All professionals found the CareLink website easy/very easy to use and were satisfied with transmission data. Conclusions: In a Portuguese population with ICD and CRT-D, RM safely reduced the burden of in-office visits, with high levels of satisfaction among patients and healthcare professionals. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://repositorio.ulisboa.pt/bitstreams/cf112e2d-bd8d-4b4d-bb39-6ebd5f1ae916/download |
| id | ul_3ec95a33fe33d596dbbf83aebde790dc |
| identifier.url.fl_str_mv | http://hdl.handle.net/10451/55431 |
| instacron_str | ul |
| institution | Universidade de Lisboa |
| instname_str | Universidade de Lisboa |
| language | eng |
| network_acronym_str | ul |
| network_name_str | Repositório da Universidade de Lisboa |
| oai_identifier_str | oai:repositorio.ulisboa.pt:10451/55431 |
| organization_str_mv | urn:organizationAcronym:ul |
| person_str_mv | Oliveira, Mário Fernandes, Milene Fernandes, Milene http://orcid.org/0000-0002-6603-5092 0000-0002-6603-5092 Reis, Hipólito Primo, João Sanfins, Victor Silva, Vânia Cunha, Pedro Silva Silva, Mónica Nicola, Paulo Jorge Morais Zamith Nicola, Paulo Jorge Morais Zamith https://www.ciencia-id.pt/EC13-192D-69C8 EC13-192D-69C8 http://orcid.org/0000-0003-0175-8457 0000-0003-0175-8457 |
| publishDate | 2022 |
| publisher.none.fl_str_mv | Elsevier |
| reponame_str | Repositório da Universidade de Lisboa |
| repository_id_str | urn:repositoryAcronym:ul |
| service_str_mv | urn:repositoryAcronym:ul |
| spelling | engElsevierpt_PTIntroduction: Remote monitoring (RM) is a safe and effective alternative to in-office conventional follow-up. Objective: We aimed to evaluate patient satisfaction with RM and its impact on healthcare resources in a population with cardiac implantable electronic devices. Methods: Randomized, pragmatic, open-label controlled trial, with adult wearers of implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy with ICD (CRT-D), eligible for the CareLink® system. Patients newly implanted or with previous conventional follow-up were randomized to RM or conventional follow-up (control), and followed for 12 months, according to the centers' practice. The number of in-office visits and adverse events were compared between groups. Patient and healthcare professionals' satisfaction with RM were described. Results: Of the 134 randomized patients (69 RM; 65 control, aged 60±13 years), 80% were male, 23% employed, 72% ICD wearers and 54% newly implanted. Most patients (70%) reported travel costs less than 15€/visit, and 46% daily routine interference with in-office visits. Median physician/technician time with patient was 15 min/15 min, per in-office visit. Excluding baseline and final visits, control patients had more in-office visits in total: median 1 vs. 0, p<0.001. In 81% of the in-office visits, no clinical measures were taken. There were 10 adverse events, with no differences between groups. At the final visit, 95% of RM patients considered RM easy/very easy to use, and would all prefer to maintain RM and recommend it to others. All professionals found the CareLink website easy/very easy to use and were satisfied with transmission data. Conclusions: In a Portuguese population with ICD and CRT-D, RM safely reduced the burden of in-office visits, with high levels of satisfaction among patients and healthcare professionals.application/pdfpt_PTRemote versus in-office monitoring for implantable cardioverter defibrillators: results from a randomized pragmatic controlled study in PortugalAlternativeTitlept_PTMonitoração remota versus seguimento hospitalar presencial em portadores de cardioversor-desfibrilhador: resultados dum estudo randomizado em PortugalOliveira, MárioPersonalFernandes, MileneDSpacehttp://dspace.org/items/19e0d31e-2a54-4d5d-80b7-4d42ace08111DSpacehttp://dspace.org/items/19e0d31e-2a54-4d5d-80b7-4d42ace08111FernandesMileneORCIDhttp://orcid.org0000-0002-6603-5092Reis, HipólitoPrimo, JoãoSanfins, VictorSilva, VâniaCunha, Pedro SilvaSilva, MónicaPersonalNicola, Paulo Jorge Morais ZamithDSpacehttp://dspace.org/items/b43213c5-6a7a-4779-904e-19909e396b89DSpacehttp://dspace.org/items/b43213c5-6a7a-4779-904e-19909e396b89Morais Zamith NicolaPaulo JorgeCiência IDhttps://www.ciencia-id.ptEC13-192D-69C8ORCIDhttp://orcid.org0000-0003-0175-8457Scopus Author IDhttps://www.scopus.com7003405044HostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@reitoria.ulisboa.ptrepositorio@reitoria.ulisboa.ptISSNIsPartOf0870-2551DOIIsPartOf10.1016/j.repc.2021.08.0172022-12-16T15:50:07Z20222022-01-01T00:00:00ZHandlehttp://hdl.handle.net/10451/55431http://purl.org/coar/access_right/c_abf2open accessImplantable cardioverter-defibrillatorFollow-upRemote monitoring727505 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal article2022http://creativecommons.org/licenses/by-nc-nd/4.0/http://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/cf112e2d-bd8d-4b4d-bb39-6ebd5f1ae916/downloadRevista Portuguesa de Cardiologia4112987997 |
| spellingShingle | Remote versus in-office monitoring for implantable cardioverter defibrillators: results from a randomized pragmatic controlled study in Portugal Oliveira, Mário Implantable cardioverter-defibrillator Follow-up Remote monitoring |
| status | SINGLETON |
| subject.fl_str_mv | Implantable cardioverter-defibrillator Follow-up Remote monitoring |
| title | Remote versus in-office monitoring for implantable cardioverter defibrillators: results from a randomized pragmatic controlled study in Portugal |
| title_full | Remote versus in-office monitoring for implantable cardioverter defibrillators: results from a randomized pragmatic controlled study in Portugal |
| title_fullStr | Remote versus in-office monitoring for implantable cardioverter defibrillators: results from a randomized pragmatic controlled study in Portugal |
| title_full_unstemmed | Remote versus in-office monitoring for implantable cardioverter defibrillators: results from a randomized pragmatic controlled study in Portugal |
| title_short | Remote versus in-office monitoring for implantable cardioverter defibrillators: results from a randomized pragmatic controlled study in Portugal |
| title_sort | Remote versus in-office monitoring for implantable cardioverter defibrillators: results from a randomized pragmatic controlled study in Portugal |
| topic | Implantable cardioverter-defibrillator Follow-up Remote monitoring |
| topic_facet | Implantable cardioverter-defibrillator Follow-up Remote monitoring |
| url | http://hdl.handle.net/10451/55431 |
| visible | 1 |