Cost-Utility Analysis of the EVOLVO Study on Remote Monitoring for Heart Failure Patients With Implantable Defibrillators: Randomized Controlled Trial

Zanaboni, Paolo; Landolina, Maurizio; Marzegalli, Maurizio; Lunati, Maurizio; Perego, Giovanni Battista; Guenzati, Giuseppe; Curnis, Antonio; Valsecchi, Sergio; Borghetti, F.; Borghi, Gabriella; Masella, Cristina

doi:10.2196/jmir.2587

Cited by 66 publications

(96 citation statements)

References 33 publications

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“…Other important contributions are done in the remote management or monitoring of cardiac devices such as pacemakers, in order to assess their correct operation and to perform periodic checks, which is currently very common in modern health care facilities [45]. …”

Section: Discussionmentioning

confidence: 99%

Mobile Apps in Cardiology: Review

Martínez-Pérez¹,

Díez²,

López-Coronado³

et al. 2013

JMIR Mhealth Uhealth

123

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BackgroundCardiovascular diseases are the deadliest diseases worldwide, with 17.3 million deaths in 2008 alone. Among them, heart-related deaths are of the utmost relevance; a fact easily proven by the 7.25 million deaths caused by ischemic heart disease alone in that year. The latest advances in smartphones and mHealth have been used in the creation of thousands of medical apps related to cardiology, which can help to reduce these mortality rates.ObjectiveThe aim of this paper is to study the literature on mobile systems and applications currently available, as well as the existing apps related to cardiology from the leading app stores and to then classify the results to see what is available and what is missing, focusing particularly on commercial apps.MethodsTwo reviews have been developed. One is a literature review of mobile systems and applications, retrieved from several databases and systems such as Scopus, PubMed, IEEE Xplore, and Web of Knowledge. The other is a review of mobile apps in the leading app stores, Google play for Android and Apple’s App Store for iOS.ResultsSearch queries up to May 2013 located 406 papers and 710 apps related to cardiology and heart disease. The most researched section in the literature associated with cardiology is related to mobile heart (and vital signs) monitoring systems and the methods involved in the classification of heart signs in order to detect abnormal functions. Other systems with a significant number of papers are mobile cardiac rehabilitation systems, blood pressure measurement, and systems for the detection of heart failure. The majority of apps for cardiology are heart monitors and medical calculators. Other categories with a high number of apps are those for ECG education and interpretation, cardiology news and journals, blood pressure tracking, heart rate monitoring using an external device, and CPR instruction. There are very few guides on cardiac rehabilitation and apps for the management of the cardiac condition, and there were no apps that assist people who have undergone a heart transplant.ConclusionsThe distribution of work in the field of cardiology apps is considerably disproportionate. Whereas some systems have significant research and apps are available, other important systems lack such research and lack apps, even though the contribution they could provide is significant.

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Section: Discussionmentioning

confidence: 99%

Mobile Apps in Cardiology: Review

Martínez-Pérez¹,

Díez²,

López-Coronado³

et al. 2013

JMIR Mhealth Uhealth

123

View full text Add to dashboard Cite

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“…172 It was based on the costs incurred by all patients who called the local emergency service in 2012 and had a pre-hospital triage for those with suspected acute cardiac disease (n = 109,750 Another cost analysis of implantable defibrillators was based on an RCT (n = 200). 174 Patients with implantable defibrillators with wireless transmission were randomized between remote monitoring and conventional care and were followed up for 16 months. No significant cost savings for the healthcare system were observed, but there was a significant reduction in cost for patients.…”

Section: Cost-effectiveness Analysismentioning

confidence: 99%

The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

Bashshur

Shannon

Smith

et al. 2014

Telemedicine and e-Health

309

210

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The telemedicine intervention in chronic disease management promises to involve patients in their own care, provides continuous monitoring by their healthcare providers, identifies early symptoms, and responds promptly to exacerbations in their illnesses. This review set out to establish the evidence from the available literature on the impact of telemedicine for the management of three chronic diseases: congestive heart failure, stroke, and chronic obstructive pulmonary disease. By design, the review focuses on a limited set of representative chronic diseases because of their current and increasing importance relative to their prevalence, associated morbidity, mortality, and cost. Furthermore, these three diseases are amenable to timely interventions and secondary prevention through telemonitoring. The preponderance of evidence from studies using rigorous research methods points to beneficial results from telemonitoring in its various manifestations, albeit with a few exceptions. Generally, the benefits include reductions in use of service: hospital admissions/readmissions, length of hospital stay, and emergency department visits typically declined. It is important that there often were reductions in mortality. Few studies reported neutral or mixed findings.

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“…Similarly, the adoption of new organizational models in the centers is warranted, in order to effectively and efficiently implement RM in standard clinical practice, converting this innovative approach to a cost-saving solution for patients, hospitals, and the public payer [23,25]. …”

Section: Discussionmentioning

confidence: 99%

Remote Monitoring for Implantable Defibrillators: A Nationwide Survey in Italy

Luzi¹,

Simone²,

Leoni³

et al. 2013

Interact J Med Res

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BackgroundRemote monitoring (RM) permits home interrogation of implantable cardioverter defibrillator (ICD) and provides an alternative option to frequent in-person visits.ObjectiveThe Italia-RM survey aimed to investigate the current practice of ICD follow-up in Italy and to evaluate the adoption and routine use of RM.MethodsAn ad hoc questionnaire on RM adoption and resource use during in-clinic and remote follow-up sessions was completed in 206 Italian implanting centers.ResultsThe frequency of routine in-clinic ICD visits was 2 per year in 158/206 (76.7%) centers, 3 per year in 37/206 (18.0%) centers, and 4 per year in 10/206 (4.9%) centers. Follow-up examinations were performed by a cardiologist in 203/206 (98.5%) centers, and by more than one health care worker in 184/206 (89.3%) centers. There were 137/206 (66.5%) responding centers that had already adopted an RM system, the proportion of ICD patients remotely monitored being 15% for single- and dual-chamber ICD and 20% for cardiac resynchronization therapy ICD. Remote ICD interrogations were scheduled every 3 months, and were performed by a cardiologist in 124/137 (90.5%) centers. After the adoption of RM, the mean time between in-clinic visits increased from 5 (SD 1) to 8 (SD 3) months (P<.001).ConclusionsIn current clinical practice, in-clinic ICD follow-up visits consume a large amount of health care resources. The results of this survey show that RM has only partially been adopted in Italy and, although many centers have begun to implement RM in their clinical practice, the majority of their patients continue to be routinely followed-up by means of in-clinic visits.

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Cost-Utility Analysis of the EVOLVO Study on Remote Monitoring for Heart Failure Patients With Implantable Defibrillators: Randomized Controlled Trial

Cited by 66 publications

References 33 publications

Mobile Apps in Cardiology: Review

Mobile Apps in Cardiology: Review

The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

Remote Monitoring for Implantable Defibrillators: A Nationwide Survey in Italy

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