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Impact of in-clinic follow-up visits in patients with implantable cardioverter defibrillators: demographic and socioeconomic analysis of the TARIFF study population

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Remote monitoring of cardiac implantable electronic devices has been demonstrated to safely reduce frequency of hospital visits. Limited studies are available evaluating the economic impact. The aim of this article is to highlight the social impact and costs for the patients associated with hospital visits for routine device follow-up at the enrollment visit for the TARIFF study (NCT01075516).

Methods

TARIFF is a prospective, cohort, observational study designed to compare the costs and impact on quality of life between clinic-based and remote care device follow-up strategies.

Results

Two hundred nine patients (85.2 % males) were enrolled in the study; 153 patients (73.2 %) were retired, 36 (17.2 %) were active workers, 18 (8.6 %) were housewives, and 2 (1.0 %) were looking for a job. Among active workers, 63.9 % required time off from work to attend the hospital visit, while 67.0 % of all patients had to interrupt daily activities. The majority of patients spent half a day or more attending the visit. A carer accompanied 77 % of patients. Among carers, 36.6 % required time off from work, and 77.6 % had to interrupt daily activities. Median distance traveled was 36 km. The average cost of travel was 10 euros with 25 % of patients spending more than 30 euros.

Conclusions

Data from patients enrolled in the TARIFF registry confirm that there are social and economic impacts to patients attending routine device checks in hospital which can be significantly reduced by using a remote monitoring strategy.

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References

  1. Neuzil, P., Taborsky, M., Holy, F., & Wallbrueck, K. (2008). Early automatic remote detection of combined lead insulation defect and ICD damage. Europace, 10, 556–557.

    Article  PubMed  Google Scholar 

  2. Varma, N. (2009). Remote monitoring for advisories: automatic early detection of silent lead failure. Pacing and Clinical Electrophysiology, 32, 525–527.

    Article  PubMed  Google Scholar 

  3. Spencker, S., Coban, N., Koch, L., Schirdewan, A., & Muller, D. (2009). Potential role of home monitoring to reduce inappropriate shocks in implantable cardioverterdefibrillator patients due to lead failure. Europace, 11, 483–488.

    Article  PubMed  Google Scholar 

  4. Varma, N., Epstein, A., Irimpen, A., Schweikert, R., Shah, J., Love, C. J., & for the TRUST Investigators. (2010). Efficacy and safety of automatic remote monitoring for ICD follow-up: the TRUST trial. Circulation, 122, 325–332.

    Article  PubMed  Google Scholar 

  5. Ricci, R. P., Morichelli, L., & Santini, M. (2009). Remote control of implanted devices through home monitoring technology improves detection and clinical management of atrial fibrillation. Europace, 11, 54–61.

    Article  PubMed  Google Scholar 

  6. Ricci, R. P., Morichelli, L., D’Onofrio, A., Calò, L., Vaccari, D., Zanotto, G., Curnis, A., Buja, G., Rovai, N., & Gargaro, A. (2013). Effectiveness of remote monitoring of cardiac implantable electronic devices in detection and treatment of clinical and device-related cardiovascular events in daily practice. The HomeGuide Registry. Europace. doi:10.1093/europace/eus440.

    Google Scholar 

  7. Whellan, D. J., Ousdigian, K. T., Al-Khatib, S. M., Pu, W., Sarkar, S., Porter, C. B., Pavri, B. B., & O’Connor, C. M. (2010). Combined heart failure device diagnostics identify patients at higher risk of subsequent heart failure hospitalizations: results from PARTNERS HF (Program to Access and Review Trending Information and Evaluate Correlation to Symptoms in Patients With Heart Failure) study. Journal of the American College of Cardiology, 55, 1803–1810.

    Article  PubMed  Google Scholar 

  8. Ricci, R. P., Morichelli, L., Gargaro, A., Laudadio, M. T., & Santini, M. (2009). Home monitoring in patients with implantable cardiac devices: is there a potential reduction of stroke risk? Results from a computer model tested through Monte Carlo simulations. Journal of Cardiovascular Electrophysiology, 20(11), 1244–1251.

    Article  PubMed  Google Scholar 

  9. Dubner, S., Auricchio, A., Steinberg, J. S., Vardas, P., Stone, P., et al. (2012). ISHNE/EHRA expert consensus on remote monitoring of cardiovascular implantable electronic devices (CIEDs). Europace, 14(2), 278–293.

    Article  PubMed  Google Scholar 

  10. Crossley, G. H., Boyle, A., Vitense, A., Chang, Y., Mead, R. H., & for the CONNECT Investigators. (2011). The CONNECT (Clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision) trial: the value of wireless remote monitoring with automatic clinician alerts. Journal of the American College of Cardiology, 57(10), 1182–1189.

    Article  Google Scholar 

  11. Landolina, M., Perego, G., Lunati, M., Curnis, A., Guenzati, G., et al. (2012). Remote monitoring reduces healthcare use and improves quality of care in heart failure patients with implantable defibrillators: the evolution of management strategies of heart failure patients with implantable defibrillators (EVOLVO) study. Circulation, 125(24), 2985–2992.

    Article  PubMed  Google Scholar 

  12. Klersy, C., De Silvestri, A., Gabutti, G., Raisaro, A., Curti, M., et al. (2011). Economic impact of remote patient monitoring: an integrated economic model derived from a meta-analysis of randomized controlled trials in heart failure. European Journal of Heart Failure, 13, 450–459.

    Article  PubMed  Google Scholar 

  13. Ricci, R. P., Morichelli, L., Quarta, L., Sassi, A., Porfili, A., Laudadio, M. T., Gargaro, A., & Santini, M. (2010). Long-term patient acceptance of and satisfaction with implanted device remote monitoring. Europace, 12, 674–679.

    Article  PubMed  Google Scholar 

  14. Gramegna, L., Tomasi, C., Gasparini, G., Scaboro, G., Zanon, F., Boaretto, G., et al. (2012). In-hospital follow-up of implantable cardioverter defibrillator and pacemaker carriers: patients' inconvenience and points of view. A four-hospital Italian survey. Europace, 14, 345–350.

    Article  PubMed  Google Scholar 

  15. Le Goff-Pronost, M., & Sicotte, C. (2010). The added value of thorough economic evaluation of telemedicine networks. The European Journal of Health Economics, 11, 45–55.

    Article  PubMed  Google Scholar 

  16. Raatikainen, M. J. P., Uusimaa, P., van Ginneken, M. E. M., Janssen, J. P. G., & Linnaluoto, M. (2008). Remote monitoring of implantable cardioverter defibrillator patients: a safe, time-saving, and cost-effective means for follow-up. Europace, 10, 1145–1151.

    Article  PubMed  Google Scholar 

  17. Burri, H., Heidbuchel, H., Jung, W., & Brugada, P. (2011). Remote monitoring: a cost or an investment? Europace, 13, ii44–ii48.

    Article  PubMed  Google Scholar 

  18. Ricci, R. P., D'Onofrio, A., Padeletti, L., Sagone, A., Vicentini, A., et al. (2012). Rationale and design of the health economics evaluation registry for remote follow-up: TARIFF. Europace, 14(11), 1661–1665.

    Article  PubMed  Google Scholar 

  19. Mabo, P., Victor, F., Bazin, P., Ahres, S., Babuty, D., Da Costa, A., Binet, D., & Daubert, J. C. (2012). A randomized trial of long-term remote monitoring of pacemaker recipients (The COMPAS trial). European Heart Journal, 33, 1105–1011.

    Article  PubMed  Google Scholar 

  20. Elsner, C. H., Sommer, P., Piorkowski, C., Taborsky, M., Neuser, H., Bytesnik, J., Geller, J. C., Kottkamp, H., Wiesmeth, H., & Hindricks, G. (2006). A prospective multicenter comparison trial of home monitoring against regular follow-up in MADIT II patients: additional visits and cost impact. Computers in Cardiology, 33, 241–244.

    Google Scholar 

  21. Mascioli, G., Curnis, A., Landolina, M., Klersy, C., & Gelmini, G. P. (2011). Actions elicited during scheduled and unscheduled in-hospital follow-up of cardiac devices: results of the ATHENS multicentre registry. Europace, 13, 1766–1773.

    Article  PubMed  Google Scholar 

  22. Heidbuchel, H., Lioen, P., Foulon, S., Huybrechts, W., Ector, J., Willems, R., & Ector, H. (2008). Potential role of remote monitoring for scheduled and unscheduled evaluations of patients with an implantable defibrillator. Europace, 10, 351–357.

    Article  PubMed  Google Scholar 

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Conflict of interest

A.D. and A.P. are employees of St. Jude Medical.

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Authors and Affiliations

  1. Department of Cardiology, San Filippo Neri Hospital, Via Martinotti, 20, 00135, Rome, Italy

    Renato P. Ricci, Loredana Morichelli & Massimo Santini

  2. Department of Cardiology, Casa di Cura Pederzoli, Peschiera del Garda, Italy

    Alfredo Vicentini & Antonio Fusco

  3. Cardiology Division, V. Monaldi Hospital, Naples, Italy

    Antonio D’Onofrio & Filippo Vecchione

  4. Department of Cardiology, L. Sacco Hospital, Milan, Italy

    Antonio Sagone & Francesco Lo Presti

  5. Electrophysiology and Cardiac Pacing Unit, San Gerardo Hospital, Monza, Italy

    Antonio Vincenti

  6. Department of Cardiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Luigi Padeletti

  7. Clinical Department, St. Jude Medical Italy, Centro Dir Colleoni, Milan, Italy

    Alessandra Denaro & Annalisa Pollastrelli

Authors
  1. Renato P. Ricci
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  2. Alfredo Vicentini
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  3. Antonio D’Onofrio
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  4. Antonio Sagone
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  5. Antonio Vincenti
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  6. Luigi Padeletti
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  7. Loredana Morichelli
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  8. Antonio Fusco
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  9. Filippo Vecchione
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  10. Francesco Lo Presti
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  11. Alessandra Denaro
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  12. Annalisa Pollastrelli
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  13. Massimo Santini
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Corresponding author

Correspondence to Renato P. Ricci.

Additional information

Trial registration: NCT01075516

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Ricci, R.P., Vicentini, A., D’Onofrio, A. et al. Impact of in-clinic follow-up visits in patients with implantable cardioverter defibrillators: demographic and socioeconomic analysis of the TARIFF study population. J Interv Card Electrophysiol 38, 101–106 (2013). https://doi.org/10.1007/s10840-013-9823-5

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  • DOI: https://doi.org/10.1007/s10840-013-9823-5

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