Background Mobile computing and communication technologies in health services and information (so-called mHealth) have modified the traditional approach in the follow-up of patients with implantable cardiac devices, increased patient engagement and empowerment, reduced healthcare costs and improved patients' outcome. Recent developments in mobile technology, with the introduction of smartphone-compatible devices that can measure various health parameters and transfer automatically generated data, have increased the potential application of remote monitoring and the interest towards mHealth. However, little is known about the patients' interest and expectations of this new technology. Objective The patients' interest in the possibility of receiving data from their implantable cardiac device, clinical and health advice via remote monitoring on their smartphones were investigated. Methods A questionnaire entitled ‘Expectations for future possibility of self-management of device data’ (Likert scale scored) was submitted to 300 consecutive implantable cardiac device outpatients. The questionnaire was focused on collecting patients’ expectations in receiving direct information regarding their implantable cardiac device status (item 1, five questions), their own clinical status (item 2, seven questions) and advice on healthy lifestyle promotion (item 3, nine questions). Patient characteristics associated with greater interest towards mHealth were also investigated. Results Questionnaires were completed by 268 patients (221 men, aged 69 ± 14 years). The Cronbach test reported an alpha value of 0.98 for item 1, 0.94 for item 2 and 0.97 for item 3. Patients declared to be mainly interested in the device interventions (62%) and in severe arrhythmia occurrence (61%), followed by data on heart failure severity (54%) and their performed physical activity (48%). Patients showed very little interest in ECG tracing (37%), but the lowest interest was expressed towards healthy lifestyle promotion advice (<40%). A higher education degree and the presence of the caregiver positively affected the interest towards remote monitoring information ( P < 0.001). Conclusions The patients' interests were mainly directed at receiving information related to technical data of the implantable cardiac device and not to the overall management of the disease, underlying the insufficient awareness of patients towards the key role of self-control health status and the promotion of a healthy lifestyle.
Purpose: According to Dutch law, ICD recipients are restricted from driving a motor vehicle for 2 months after implantation of an ICD. This requires significant lifestyle adjustments for patients and their families. Previous studies indicated that compliance with the restrictions is low, but the associated demographic, clinical and psychosocial factors have never been investigated by large European quantitative studies. Method: In this prospective multicenter cohort study of 417 Dutch patients receiving a firsttime ICD, the first 224 patients (80% men, mean age 60.4 + 12.1 years) have now completed an elaborative set of questionnaires at time of implantation (baseline) and at 4 months post-implantation. Additional clinical and follow-up data is currently being collected and will be available to present at the Cardiostim congress. Results: Non-compliant patients (28%) less often reported to understand the reason behind the driving restriction, compared with compliant patients (76% vs. 89%, p ¼ .02). No other baseline group differences were detected. Multiple logistic regression analyses (n ¼ 202) showed that baseline anxiety was positively associated with non-compliance, while understanding the reason for the restriction and Type D personality were negatively associated with non-compliance (see Table). Conclusion: Notwithstanding the restriction, a substantial proportion of ICD recipients drove a motor vehicle within 2 months after implantation. The preliminary results of our study suggest that compliance might be improved if patients' understanding of the driving restriction is checked and improved, while paying particular attention to anxious patients. Conflict of interest: none HEART FAILURE PATIENT WISHES REGARDING FUTURE IMPROVEMENTS IN CARDIAC IMPLANTABLE DEVICE REMOTE MONITORINGLuca Rossi, Andrea Villani, Diego Penela, Alessia Zanni, Concetta Sticozzi, Maria Giulia Bolognesi, Massimo Piepoli, and Giovanni Quinto Villani Piacenza, ItalyPurpose: The study aimed to investigate the patient wishes in Remote Monitoring (RM) feedbacks from their cardiac implantable device. In particular the study aimed to highlight patient expectations to receive direct information about device functions, control the own clinical status and tips on lifestyle on their smartphone. Methods: A questionnaire entitled, "Wishes for future improvements of RM", was prepared and submitted to patients attending the Device Follow up clinic in Piacenza Hospital using RM. The questionnaire is composed of three items, with 5 to7 questions each, scored using a five-point Likert scale. First item concerns the possibility to receive datas about implantable device function (electrical integrity, battery status, ecc. . .); second item regards the possibility to collect information on the clinical status; third item is related to healhty lifestyle promotion. The external and internal reliability of the questionnaire was assessed using Cronbach's alpha test. Questionnaire responses were cross-checked with a set of demographic variables (age, gender, e...
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