Remote monitoring of implantable cardioverter defibrillators: Patient experiences and preferences for follow‐up

Ivy Timmermans, Mathias Meine, Istvan Szendey, Johannes Aring, Javier Romero Roldán, Lieselotte Erven, Philipp Kahlert, Edgar Zitron, Philippe Mabo, Johan Denollet, Henneke Versteeg*

*Corresponding author for this work

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Abstract

Background
Patient satisfaction with remote patient monitoring (RPM) of implantable cardioverter defibrillators (ICDs) seems to be high, yet knowledge on long‐term patient experiences is limited. The European REMOTE‐CIED study explored patients' experiences with RPM, examined patient's preferences for ICD follow‐up, and identified determinants of patient's preferences in the first 2 years postimplantation.

Methods
European heart failure patients (N = 300; median age = 66 years [interquartile range (IQR) = 59‐73], and 22% female) with a first‐time ICD received a Boston Scientific LATITUDE RPM system (Marlborough, MA, USA) and had scheduled in‐clinic follow‐ups once a year. Patients completed questionnaires at 1‐2 weeks and also at 3, 6, 12, and 24 months postimplantation and clinical data were obtained from their medical records. Patient evaluation data were analyzed descriptively, and Student's t‐tests/Man‐Whitney U tests or Chi‐square tests/Fisher's exact tests were performed to examine determinants of patient preferences.

Results
At 2 years postimplantation, the median patient satisfaction score with the RPM system was 9 out of 10 (IQR = 8‐10), despite 53% of the patients experiencing issues (eg, failure to transmit data). Of the 221 patients who reported their follow‐up preferences, 43% preferred RPM and 19% preferred in‐clinic follow‐up. Patients with a preference for RPM were more likely to be higher educated (P = 0.04), employed (P = 0.04), and equipped with a new LATITUDE model (P = 0.04), but less likely to suffer from chronic obstructive pulmonary disease (P = 0.009).

Conclusion
In general, patients were highly satisfied with RPM, but a subgroup preferred in‐clinic follow‐up. Therefore, physicians should include patients’ concerns and preferences in the decision‐making process, to tailor device follow‐up to individual patients’ needs and preferences.
Original languageEnglish
Pages (from-to)120-129
JournalPACE. Pacing and Clinical Electrophysiology
Volume42
Issue number2
DOIs
Publication statusPublished - 2019

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Implantable Defibrillators
Patient Preference
Physiologic Monitoring
Medical Records
Physicians
Equipment and Supplies

Keywords

  • Aged
  • Defibrillators, Implantable
  • Female
  • Follow-Up Studies
  • Heart Failure/therapy
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Physiologic/methods
  • Patient Preference
  • Patient Satisfaction
  • Self Report
  • Surveys and Questionnaires
  • Telemedicine
  • METAANALYSIS
  • ELECTRONIC DEVICES
  • ACCEPTANCE
  • patient experiences
  • remote patient monitoring
  • PERSPECTIVE
  • IMPLEMENTATION
  • INTERROGATION
  • ICD
  • PERCEPTION
  • SATISFACTION
  • implantable cardioverter defibrillator
  • patient preferences
  • EXPERT CONSENSUS

Cite this

Timmermans, I., Meine, M., Szendey, I., Aring, J., Romero Roldán, J., Erven, L., ... Versteeg, H. (2019). Remote monitoring of implantable cardioverter defibrillators: Patient experiences and preferences for follow‐up. PACE. Pacing and Clinical Electrophysiology, 42(2), 120-129. https://doi.org/10.1111/pace.13574
Timmermans, Ivy ; Meine, Mathias ; Szendey, Istvan ; Aring, Johannes ; Romero Roldán, Javier ; Erven, Lieselotte ; Kahlert, Philipp ; Zitron, Edgar ; Mabo, Philippe ; Denollet, Johan ; Versteeg, Henneke. / Remote monitoring of implantable cardioverter defibrillators : Patient experiences and preferences for follow‐up. In: PACE. Pacing and Clinical Electrophysiology. 2019 ; Vol. 42, No. 2. pp. 120-129.
@article{606f8febcd4d498faa846566f4ce386a,
title = "Remote monitoring of implantable cardioverter defibrillators: Patient experiences and preferences for follow‐up",
abstract = "BackgroundPatient satisfaction with remote patient monitoring (RPM) of implantable cardioverter defibrillators (ICDs) seems to be high, yet knowledge on long‐term patient experiences is limited. The European REMOTE‐CIED study explored patients' experiences with RPM, examined patient's preferences for ICD follow‐up, and identified determinants of patient's preferences in the first 2 years postimplantation.MethodsEuropean heart failure patients (N = 300; median age = 66 years [interquartile range (IQR) = 59‐73], and 22{\%} female) with a first‐time ICD received a Boston Scientific LATITUDE RPM system (Marlborough, MA, USA) and had scheduled in‐clinic follow‐ups once a year. Patients completed questionnaires at 1‐2 weeks and also at 3, 6, 12, and 24 months postimplantation and clinical data were obtained from their medical records. Patient evaluation data were analyzed descriptively, and Student's t‐tests/Man‐Whitney U tests or Chi‐square tests/Fisher's exact tests were performed to examine determinants of patient preferences.ResultsAt 2 years postimplantation, the median patient satisfaction score with the RPM system was 9 out of 10 (IQR = 8‐10), despite 53{\%} of the patients experiencing issues (eg, failure to transmit data). Of the 221 patients who reported their follow‐up preferences, 43{\%} preferred RPM and 19{\%} preferred in‐clinic follow‐up. Patients with a preference for RPM were more likely to be higher educated (P = 0.04), employed (P = 0.04), and equipped with a new LATITUDE model (P = 0.04), but less likely to suffer from chronic obstructive pulmonary disease (P = 0.009).ConclusionIn general, patients were highly satisfied with RPM, but a subgroup preferred in‐clinic follow‐up. Therefore, physicians should include patients’ concerns and preferences in the decision‐making process, to tailor device follow‐up to individual patients’ needs and preferences.",
keywords = "Aged, Defibrillators, Implantable, Female, Follow-Up Studies, Heart Failure/therapy, Humans, Male, Middle Aged, Monitoring, Physiologic/methods, Patient Preference, Patient Satisfaction, Self Report, Surveys and Questionnaires, Telemedicine, METAANALYSIS, ELECTRONIC DEVICES, ACCEPTANCE, patient experiences, remote patient monitoring, PERSPECTIVE, IMPLEMENTATION, INTERROGATION, ICD, PERCEPTION, SATISFACTION, implantable cardioverter defibrillator, patient preferences, EXPERT CONSENSUS",
author = "Ivy Timmermans and Mathias Meine and Istvan Szendey and Johannes Aring and {Romero Rold{\'a}n}, Javier and Lieselotte Erven and Philipp Kahlert and Edgar Zitron and Philippe Mabo and Johan Denollet and Henneke Versteeg",
year = "2019",
doi = "10.1111/pace.13574",
language = "English",
volume = "42",
pages = "120--129",
journal = "PACE. Pacing and Clinical Electrophysiology",
issn = "0147-8389",
publisher = "Wiley-Blackwell",
number = "2",

}

Timmermans, I, Meine, M, Szendey, I, Aring, J, Romero Roldán, J, Erven, L, Kahlert, P, Zitron, E, Mabo, P, Denollet, J & Versteeg, H 2019, 'Remote monitoring of implantable cardioverter defibrillators: Patient experiences and preferences for follow‐up', PACE. Pacing and Clinical Electrophysiology, vol. 42, no. 2, pp. 120-129. https://doi.org/10.1111/pace.13574

Remote monitoring of implantable cardioverter defibrillators : Patient experiences and preferences for follow‐up. / Timmermans, Ivy; Meine, Mathias; Szendey, Istvan; Aring, Johannes; Romero Roldán, Javier; Erven, Lieselotte; Kahlert, Philipp; Zitron, Edgar; Mabo, Philippe; Denollet, Johan; Versteeg, Henneke.

In: PACE. Pacing and Clinical Electrophysiology, Vol. 42, No. 2, 2019, p. 120-129.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Remote monitoring of implantable cardioverter defibrillators

T2 - Patient experiences and preferences for follow‐up

AU - Timmermans, Ivy

AU - Meine, Mathias

AU - Szendey, Istvan

AU - Aring, Johannes

AU - Romero Roldán, Javier

AU - Erven, Lieselotte

AU - Kahlert, Philipp

AU - Zitron, Edgar

AU - Mabo, Philippe

AU - Denollet, Johan

AU - Versteeg, Henneke

PY - 2019

Y1 - 2019

N2 - BackgroundPatient satisfaction with remote patient monitoring (RPM) of implantable cardioverter defibrillators (ICDs) seems to be high, yet knowledge on long‐term patient experiences is limited. The European REMOTE‐CIED study explored patients' experiences with RPM, examined patient's preferences for ICD follow‐up, and identified determinants of patient's preferences in the first 2 years postimplantation.MethodsEuropean heart failure patients (N = 300; median age = 66 years [interquartile range (IQR) = 59‐73], and 22% female) with a first‐time ICD received a Boston Scientific LATITUDE RPM system (Marlborough, MA, USA) and had scheduled in‐clinic follow‐ups once a year. Patients completed questionnaires at 1‐2 weeks and also at 3, 6, 12, and 24 months postimplantation and clinical data were obtained from their medical records. Patient evaluation data were analyzed descriptively, and Student's t‐tests/Man‐Whitney U tests or Chi‐square tests/Fisher's exact tests were performed to examine determinants of patient preferences.ResultsAt 2 years postimplantation, the median patient satisfaction score with the RPM system was 9 out of 10 (IQR = 8‐10), despite 53% of the patients experiencing issues (eg, failure to transmit data). Of the 221 patients who reported their follow‐up preferences, 43% preferred RPM and 19% preferred in‐clinic follow‐up. Patients with a preference for RPM were more likely to be higher educated (P = 0.04), employed (P = 0.04), and equipped with a new LATITUDE model (P = 0.04), but less likely to suffer from chronic obstructive pulmonary disease (P = 0.009).ConclusionIn general, patients were highly satisfied with RPM, but a subgroup preferred in‐clinic follow‐up. Therefore, physicians should include patients’ concerns and preferences in the decision‐making process, to tailor device follow‐up to individual patients’ needs and preferences.

AB - BackgroundPatient satisfaction with remote patient monitoring (RPM) of implantable cardioverter defibrillators (ICDs) seems to be high, yet knowledge on long‐term patient experiences is limited. The European REMOTE‐CIED study explored patients' experiences with RPM, examined patient's preferences for ICD follow‐up, and identified determinants of patient's preferences in the first 2 years postimplantation.MethodsEuropean heart failure patients (N = 300; median age = 66 years [interquartile range (IQR) = 59‐73], and 22% female) with a first‐time ICD received a Boston Scientific LATITUDE RPM system (Marlborough, MA, USA) and had scheduled in‐clinic follow‐ups once a year. Patients completed questionnaires at 1‐2 weeks and also at 3, 6, 12, and 24 months postimplantation and clinical data were obtained from their medical records. Patient evaluation data were analyzed descriptively, and Student's t‐tests/Man‐Whitney U tests or Chi‐square tests/Fisher's exact tests were performed to examine determinants of patient preferences.ResultsAt 2 years postimplantation, the median patient satisfaction score with the RPM system was 9 out of 10 (IQR = 8‐10), despite 53% of the patients experiencing issues (eg, failure to transmit data). Of the 221 patients who reported their follow‐up preferences, 43% preferred RPM and 19% preferred in‐clinic follow‐up. Patients with a preference for RPM were more likely to be higher educated (P = 0.04), employed (P = 0.04), and equipped with a new LATITUDE model (P = 0.04), but less likely to suffer from chronic obstructive pulmonary disease (P = 0.009).ConclusionIn general, patients were highly satisfied with RPM, but a subgroup preferred in‐clinic follow‐up. Therefore, physicians should include patients’ concerns and preferences in the decision‐making process, to tailor device follow‐up to individual patients’ needs and preferences.

KW - Aged

KW - Defibrillators, Implantable

KW - Female

KW - Follow-Up Studies

KW - Heart Failure/therapy

KW - Humans

KW - Male

KW - Middle Aged

KW - Monitoring, Physiologic/methods

KW - Patient Preference

KW - Patient Satisfaction

KW - Self Report

KW - Surveys and Questionnaires

KW - Telemedicine

KW - METAANALYSIS

KW - ELECTRONIC DEVICES

KW - ACCEPTANCE

KW - patient experiences

KW - remote patient monitoring

KW - PERSPECTIVE

KW - IMPLEMENTATION

KW - INTERROGATION

KW - ICD

KW - PERCEPTION

KW - SATISFACTION

KW - implantable cardioverter defibrillator

KW - patient preferences

KW - EXPERT CONSENSUS

U2 - 10.1111/pace.13574

DO - 10.1111/pace.13574

M3 - Article

C2 - 30536931

VL - 42

SP - 120

EP - 129

JO - PACE. Pacing and Clinical Electrophysiology

JF - PACE. Pacing and Clinical Electrophysiology

SN - 0147-8389

IS - 2

ER -