Efectividad comparativa del seguimiento remoto a personas con marcapasos cardíacos frente al convencional: calidad de vida a los 6 meses

Abstract

Fundamentos: El uso del seguimiento remoto (SR) de personas portadoras de marcapasos (MP) es limitado en comparación con la modalidad hospitalaria (SH), siendo escasa la evidencia científica que muestre su efectividad. El objetivo de este estudio fue comparar la calidad de vida en personas con diferentes modalidades de seguimiento. Métodos: Ensayo clínico controlado, no aleatorizado ni enmascarado, con recogida de datos pre y post-implante del marcapasos durante los 6 meses de seguimiento. Se seleccionó a todos los pacientes mayores de 18 años a los que se les implantó un marcapasos en el periodo de estudio (n=83), siendo asignados al grupo SR (n=30) o al grupo SH (n=53), en función de sus características personales y preferencias. Se analizaron las características basales y número de visitas al hospital, y se administró el cuestionario EuroQol-5D (EQ-5D) para evaluar la calidad de vida relacionada con la salud y el Duke Activity Status Index (DASI) para valorar la capacidad funcional. Resultados: No hubo diferencias significativas entre ambos grupos en relación al análisis basal, EQ-5D (SR:0,7299; SH:0,6769) y DASI (SR:21,41; SH:19,99) iniciales. A los 6 meses la calidad de vida mejoró en

Background: The use of remote follow-up (RF) of people with pacemakers (PM) is limited in comparison to the hospital modality (HS), being still poor the scientific evidence that shows their comparative effectiveness. The aim of this study was to compare the quality of life in individuals with different modalities of follow-up. Methods: Controlled, not randomized nor masked clinical trial, with data collection at pre and post-implantation of pacemakers during the 6 months follow-up. All patients over 18 years-old who were implanted a PM during the study period were selected (n=83), and they were assigned to RF (n=30) or HF (n=53) groups according to their personal characteristics and patient’s preferences. Baseline characteristics and number of visits to the hospital were analysed, the EuroQol-5D (EQ5D) questionnaire was administered to evaluate the health-related quality of life, and Duke Activity Status Index (DASI) to assess the functional capacity. Results: There were no significant differences between both groups in relation to the baseline analysis, EQ5D (RF:0.7299; HF:0.6769) and DASI (RF:21.41; HF:19.99). At 6 months the quality of life was improved in both groups (EQ5D RF:0.8613; HF:0.8175; p=0,439) still without significant differences between them. DASI score was similar to baseline (20.51 vs 21.80). RF group performed less transmissions/visits per patient (1.57) than hospital group (1.96; relative reduction 31%; p=0.015). Conclusions: Remote follow-up of people with pacemakers might be considered as an equivalent option to the hospital follow-up in relation to the quality of life and it reduces the number of hospital visits.