Healthcare utilization in patients with first-time implantable cardioverter defibrillators (data from the WEBCARE study)

E.R. Broers, P. Lodder, V.R.M. Spek, J.W.M.G. Widdershoven, S.S. Pedersen, M. Habibovic*

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

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Abstract

Background
Knowledge of the level of healthcare utilization (HCU) and the predictors of high HCU use in patients with an implantable cardioverter defibrillator (ICD) is lacking. We examined the level of HCU and predictors associated with increased HCU in first‐time ICD patients, using a prospective study design.
Methods
ICD patients (N = 201) completed a set of questionnaires at baseline and 3, 6, and 12 months after inclusion. A hierarchical multiple linear regression with three models was performed to examine predictors of HCU.ResultsHCU was highest between baseline and 3 months postimplantation and gradually decreased during 12 months follow‐up. During the first year postimplantation, only depression (β = 0.342, P = 0.002) was a significant predictor. Between baseline and 3 months follow‐up, younger age (β = −0.220, P < 0.01), New York Heart Association class III/IV (β = 0.705, P = 0.01), and secondary indication (β = 0.148, P = 0.05) were independent predictors for increased HCU. Between 3 and 6 months follow‐up, younger age (β = −0.151, P = 0.05) and depression (β = 0.370, P < 0.001) predicted increased HCU. Between 6 and 12 months only depression (β = 0.355, P = 0.001) remained a significant predictor. 
Conclusions
Depression was an important predictor of increased HCU in ICD patients in the first year postimplantation, particularly after 3 months postimplantation. Identifying patients who need additional care and provide this on time might better meet patients’ needs and lower future HCU.
Original languageEnglish
Pages (from-to)439-446
JournalPACE. Pacing and Clinical Electrophysiology
Volume42
Issue number4
DOIs
Publication statusPublished - 2019

Keywords

  • ANXIETY
  • MANAGEMENT
  • QUALITY
  • depression
  • healthcare utilization
  • implantable cardioverter defibrillator
  • mental health

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