The Box—eHealth in the Outpatient Clinic Follow-up of Patients With Acute Myocardial Infarction: Cost-Utility Analysis (Preprint)

Abstract

BACKGROUND Smartphone compatible wearables have been released on the consumers market, enabling remote monitoring. Remote monitoring is often named as a tool to reduce cost of care. OBJECTIVE The primary purpose of this paper is to describe a cost-utility analysis of an eHealth intervention compared to regular follow-up in patients with acute myocardial infarction (AMI). METHODS In this trial, patients with an AMI were randomized in a 1:1 fashion between an eHealth intervention and regular follow-up. The remote monitoring intervention consisted of a blood pressure monitor, weight scale, electrocardiogram (ECG) device and step counter. Furthermore, two in-office outpatient clinic visits were replaced by e-visits. The control group received regular care. The differences in mean costs and quality of life per patient between both groups during one year follow-up were calculated RESULTS Mean costs per patient were €2412 for the intervention, and €2888 for the control group. This yielded cost reduction of €475 per patient. This difference was not statistically significant (95% CI -€271;€1221; P=.212). The average quality adjusted life years (QALY) in the first year of follow was 0.74 for the intervention group and 0.69 for the control (difference -0.05, 95% CI -0.09;-0.01; P=.028). CONCLUSIONS eHealth in the outpatient clinic setting in patients who suffered from acute myocardial infarction is very likely to be cost-effective compared to regular follow-up. Further research should be done to corroborate these findings in other patient populations and different care settings. CLINICALTRIAL NCT02976376 INTERNATIONAL REGISTERED REPORT RR2-10.2196/resprot.8038