Evidence-based in tele-monitoring of patients with pacemakers: The Poniente Study

Abstract

Background: Cardiac consultations are overloaded due to the increase in the number of implanted pacemakers during the last years. With the support of tele-monitoring systems, this situation is changing. But it is unknown if this technology is cost-efficient regarding to the sustainability of National Health System. Objectives: Examine the Health-Related Quality of Life (HRQoL), reliability and costs of patients using pacemakers compatible with the remote monitoring system. Methods: In this trial we selected consecutive 82 subjects among all patients who had been implanted with a pacemaker in Poniente Hospital (Almeria-Spain), between 2012-14 with a follow-up of 12 months/patient. At the same time 2 groups were created: Tele-Monitoring Group (TM=30) and Hospital Monitoring Group (HM=52): 1) The same parameters were analyzed in both groups at 4 different moments (pre-implant and months 1, 6 and 12 post-implantation). 2) Effectiveness was assessed through the administration of EuroQol-5D (EQ-5D) and Duke Activity Status Index (DASI). 3) Direct costs were estimated by micro-cost calculation and from National Health System perspective. Results: No significant differences were found between both groups according to sociodemographic characteristics and effectiveness according to EQ5D and DASI. Hospital visits were reduced in 40,79% (p<0,001) in the RM. Healthcare costs per patient were 36,35% (p<0.001) lower on remote monitoring mode. Conclusions: Although patients with pacemakers showed a similar rating in HRQoL in both groups, costs were significantly higher in hospital monitoring. This study showed that the tele-monitoring of patients with pacemakers is cost-efficient.