Economic impact of remote monitoring on ordinary follow-up of implantable cardioverter defibrillators as compared with conventional in-hospital visits. A single-center prospective and randomized study

Calò, Leonardo; Gargaro, Alessio; Ruvo, Ermenegildo De; Palozzi, Gabriele; Sciarra, Luigi; Rebecchi, Marco; Guarracini, Fabrizio; Fagagnini, Alessandro; Piroli, Enrico; Lioy, Ernesto; Chirico, Antonio

doi:10.1007/s10840-013-9783-9

Cited by 45 publications

(39 citation statements)

References 21 publications

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“…16 Remote monitoring, on the other hand, is time saving. 4,5,17 The equipment of patients with transmitters and their registration on the site of telemonitoring can be assumed by paramedical staff. Furthermore, this time is more than compensated by the decreased number of ambulatory visits.…”

Section: Discussionmentioning

confidence: 99%

Costs of remote monitoring vs. ambulatory follow-ups of implanted cardioverter defibrillators in the randomized ECOST study

et al. 2014

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AimsThe Effectiveness and Cost of ICD follow-up Schedule with Telecardiology (ECOST) trial evaluated prospectively the economic impact of long-term remote monitoring (RM) of implantable cardioverter defibrillators (ICDs).Methods and resultsThe analysis included 310 patients randomly assigned to RM (active group) vs. ambulatory follow-ups (control group). Patients in the active group were seen once a year unless the system reported an event mandating an ambulatory visit, while patients in the control group were seen in the ambulatory department every 6 months. The costs of each follow-up strategy were compared, using the actual billing documents issued by the French health insurance system, including costs of (i) (a) ICD-related ambulatory visits and transportation, (b) other ambulatory visits, (c) cardiovascular treatments and procedures, and (ii) hospitalizations for the management of cardiovascular events. The ICD and RM system costs were calculated on the basis of the device remaining longevity at the end of the study. The characteristics of the study groups were similar. Over a follow-up of 27 months, the mean non-hospital costs per patient-year were €1695 ± 1131 in the active, vs. €1952 ± 1023 in the control group (P = 0.04), a €257 difference mainly due to device management. The hospitalization costs per patient-year were €2829 ± 6382 and €3549 ± 9714 in the active and control groups, respectively (P = 0.46). Adding the ICD to the non-hospital costs, the savings were €494 (P = 0.005) or, when the monitoring system was included, €315 (P = 0.05) per patient-year.ConclusionFrom the French health insurance perspective, the remote management of ICD patients is cost saving.Clinical trials registrationNCT00989417,

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Section: Discussionmentioning

confidence: 99%

Costs of remote monitoring vs. ambulatory follow-ups of implanted cardioverter defibrillators in the randomized ECOST study

et al. 2014

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“…In the few studies of patient satisfaction that are available, a number of studies 28,38 have reported no difference in the quality of life and patient satisfaction when comparing remote and conventional follow-up strategies. Other authors 21,36,39,40 have reported a high rate of patient satisfaction for diverse aspects such as patient's perceived relationship with their health care providers, ease of use, psychological impact, and the ability to maintain follow-up compliance, even with nonwireless transceivers.…”

Section: Patient Satisfaction and Quality Of Lifementioning

confidence: 99%

HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices

et al. 2015

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“…Seven trials examined the costs of RPM compared to in‐clinic follow‐up . Two trials indicated cost savings on hospital level, yet three other trials did not .…”

Section: Randomized Clinical Trials On Rpmmentioning

confidence: 99%

“…Seven trials examined the costs of RPM compared to in‐clinic follow‐up . Two trials indicated cost savings on hospital level, yet three other trials did not . There was also evidence for cost savings for patients and per device due to increased device longevity .…”

Section: Randomized Clinical Trials On Rpmmentioning

confidence: 99%

“…All trials included clinical endpoints. Most examined were (un)scheduled hospital visits, [18][19][20][21][22][23][24][25][26][27] time-to-event detection or clinical decision making, 19,20,22,24,25 hospitalizations, 18,19,26,28 and mortality or survival. 20,24,28 Metaanalyses of these trials indicated that clinical outcomes of RPM are comparable to in-clinic follow-up in terms of all-cause mortality, cardiovascular mortality, and hospitalization rates.…”

Section: Introductionmentioning

confidence: 99%

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The patient perspective on remote monitoring of patients with an implantable cardioverter defibrillator: Narrative review and future directions

Timmermans

Meine

Zitron

et al. 2017

Pacing Clinical Electrophis

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Although RPM seems to be safe, effective, timely, and efficient, the patient perspective has received little attention so far. The scarce evidence on patient-reported outcomes in RPM studies seems to be positive, but future trials with a follow-up of ≥12 months and validated patient-reported outcome measures are needed. The REMOTE-CIED study from our group is the first prospective randomized controlled trial primarily designed to examine the patient perspective on RPM, and is powered to identify characteristics associated with RPM satisfaction and benefit. Results are expected in 2018 and will add valuable information to the current evidence.

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Economic impact of remote monitoring on ordinary follow-up of implantable cardioverter defibrillators as compared with conventional in-hospital visits. A single-center prospective and randomized study

Cited by 45 publications

References 21 publications

Costs of remote monitoring vs. ambulatory follow-ups of implanted cardioverter defibrillators in the randomized ECOST study

Costs of remote monitoring vs. ambulatory follow-ups of implanted cardioverter defibrillators in the randomized ECOST study

HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices

The patient perspective on remote monitoring of patients with an implantable cardioverter defibrillator: Narrative review and future directions

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