Pacing and clinical electrophysiology : PACE | 2021
The value of remote care in the reduction of healthcare utilization in implantable cardioverter-defibrillator patients.
Abstract
BACKGROUND\nMinimal evidence is available of the reduction in healthcare utilization of remote care in ICD patients over a longer period of follow-up.\n\n\nOBJECTIVES\nThis study compared healthcare utilization up to three year follow-up in implantable cardioverter-defibrillator (ICD) patients with remote care compared to conventional care.\n\n\nMETHODS\nWe conducted a retrospective cohort study of patients who received a single or dual-chamber ICD or cardiac resynchronization therapy-defibrillator (CRT-D) between 2016-2018. Patients with remote care and patients were compared with patients with received conventional care (control group). The primary endpoint was a composite of cardiac follow-up visits, ICD follow-up visits, telephone consultations, emergency department visits and hospital admissions and was defined as total healthcare utilization. The secondary endpoints were the individual care activities and one-year all-cause mortality.\n\n\nRESULTS\nA total of 497 patients were included in the study, of which 299 patients were allocated to the remote care and 198 patients to the control group. Mean follow-up was 815 ± 279 days. Remote care was associated with a significantly lower rate of adjusted total healthcare utilization in comparison to the control group that sustained for three subsequent follow-up years (IRR = 0.78, 95% CI [0.67 - 0.92], P <0.01). One-year all-cause mortality was similar between the remote care and control group (respectively 3.0% vs 5.5%, p = 0.29).\n\n\nCONCLUSIONS\nCompared to the standard follow-up of in-office care, a remote care program was associated with a sustained lower rate of planned and unplanned healthcare utilization up to 3 subsequent years after ICD/CRT-D implantation. This article is protected by copyright. All rights reserved.