Antonio López-Villegas

Efectividad Comparativa del Seguimiento Remoto a Personas con Marcapasos Cardíacos Frente al Convencional: Calidad de Vida a los 6 Meses

Fundamentos: El uso del seguimiento remoto (SR) de personas portadoras de marcapasos (MP) es limitado en comparacion con la modalidad hospitalaria (SH), siendo escasa la evidencia cientifica que muestre su efectividad. El objetivo de este estudio fue comparar la calidad de vida en personas con diferentes modalidades de seguimiento. Metodos: Ensayo clinico controlado, no aleatorizado ni enmascarado, con recogida de datos pre y post-implante del marcapasos durante los 6 meses de seguimiento. Se selecciono a todos los pacientes mayores de 18 anos a los que se les implanto un marcapasos en el periodo de estudio (n = 83), siendo asignados al grupo SR (n = 30) o al grupo SH (n = 53), en funcion de sus caracteristicas personales y preferencias. Se analizaron las caracteristicas basales y numero de visitas al hospital, y se administro 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 relacion al analisis 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 mejoro en ambos grupos (SR:0,8613; SH:0,8175; p = 0,439) aun sin diferencias estadisticamente significativas entre ellos. La puntuacion final en el DASI fue similar a la basal (20,51 vs 21,80). El grupo de SR realizo menos visitas/transmisiones por paciente (1,57) que el grupo hospitalario (1,96), la reduccion relativa fue del 31% (p = 0,015). Conclusiones: El seguimiento remoto de personas portadoras de marcapasos se podria considerar como una opcion equivalente al hospitalario en relacion a la calidad de vida y reduce el numero de visitas al hospital.

A Systematic Review of Economic Evaluations of Pacemaker Telemonitoring Systems.

INTRODUCTION AND OBJECTIVES Over the last decade, telemedicine applied to pacemaker monitoring has undergone extraordinary growth. It is not known if telemonitoring is more or less efficient than conventional monitoring. The aim of this study was to carry out a systematic review analyzing the available evidence on resource use and health outcomes in both follow-up modalities. METHODS We searched 11 databases and included studies published up until November 2014. The inclusion criteria were: a) experimental or observational design; b) studies based on complete economic evaluations; c) patients with pacemakers, and d) telemonitoring compared with conventional hospital monitoring. RESULTS Seven studies met the inclusion criteria, providing information on 2852 patients, with a mean age of 81 years. The main indication for device implantation was atrioventricular block. With telemonitoring, cardiovascular events were detected and treated 2 months earlier than with conventional monitoring, thus reducing length of hospital stay by 34% and reducing routine and emergency hospital visits as well. There were no significant intergroup differences in perceived quality of life or number of adverse events. The cost of telemonitoring was 60% lower than that of conventional hospital monitoring. CONCLUSIONS Compared with conventional monitoring, cardiovascular events were detected earlier and the number or hospitalizations and hospital visits was reduced with pacemaker telemonitoring. In addition, the costs associated with follow-up were lower with telemonitoring.

Effectiveness of pacemaker tele-monitoring on quality of life, functional capacity, event detection and workload: The PONIENTE trial.

The purpose of the present study was to assess the effectiveness of the remote monitoring (RM) of older adults with pacemakers on health‐related quality of life, functional capacity, feasibility, reliability and safety.