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Knowledge Update on the Economic Evaluation of Pacemaker Telemonitoring Systems

Author

Listed:
  • Antonio Lopez-Villegas

    (Social Involvement of Critical and Emergency Medicine, CTS-609 Research Group, Poniente Hospital, 04700 El Ejido-Almería, Spain)

  • César Leal-Costa

    (Nursing Department, University of Murcia, 30120 Murcia, Spain)

  • Mercedes Perez-Heredia

    (Research Management Department, Primary Care District Poniente of Almería, 04700 El Ejido-Almería, Spain)

  • Irene Villegas-Tripiana

    (Research Support Unit and Library, Poniente Hospital, 04700 El Ejido-Almería, Spain)

  • Daniel Catalán-Matamoros

    (UC3M MediaLab, Department of Communication and Media Studies, Madrid University Carlos III, 28903 Madrid, Spain
    Health Sciences Research Institute, University of Almería, 04120 Almería, Spain)

Abstract

(1) Introduction: In the last two decades, telemedicine has been increasingly applied to telemonitoring (TM) of patients with pacemakers; however, presently, its growth has significantly accelerated because of the COVID-19 pandemic, which has pushed patients and healthcare workers alike to seek new ways to stay healthy with minimal physical contact. Therefore, the main objective of this study was to update the current knowledge on the differences in the medium-and long-term effectiveness of TM and conventional monitoring (CM) in relation to costs and health outcomes. (2) Methods: Three databases and one scientific registry were searched (PubMed, EMBASE, Scopus, and Google Scholar), with no restrictions on language or year of publication. Studies published until July 2021 were included. The inclusion criteria were: (a) experimental or observational design, (b) complete economic evaluation, (c) patients with implanted pacemakers, and (d) comparison of TM with CM. Measurements of study characteristics (author, study duration, sample size, age, sex, major indication for implantation, and pacemaker used), analysis, significant results of the variables (analysis performed, primary endpoints, secondary endpoints, health outcomes, and cost outcomes), and further miscellaneous measurements (methodological quality, variables coded, instrument development, coder training, and intercoder reliability, etc.) were included. (3) Results: 11 studies met the inclusion criteria, consisting of 3372 enrolled patients; 1773 (52.58%) of them were part of randomized clinical trials. The mean age was 72 years, and the atrioventricular block was established as the main indication for device implantation. TM was significantly effective in detecting the presence or absence of pacemaker problems, leading to a reduction in the number of unscheduled hospital visits (8.34–55.55%). The cost of TM was up to 87% lower than that of CM. There were no significant differences in health-related quality of life (HRQoL) and the number of cardiovascular events. (4) Conclusions: Most of the studies included in this systematic review confirm that in the TM group of patients with pacemakers, cardiovascular events are detected and treated earlier, and the number of unscheduled visits to the hospital is significantly reduced, without affecting the HRQoL of patients. In addition, with TM modality, both formal and informal costs are significantly reduced in the medium and long term.

Suggested Citation

  • Antonio Lopez-Villegas & César Leal-Costa & Mercedes Perez-Heredia & Irene Villegas-Tripiana & Daniel Catalán-Matamoros, 2021. "Knowledge Update on the Economic Evaluation of Pacemaker Telemonitoring Systems," IJERPH, MDPI, vol. 18(22), pages 1-22, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:22:p:12120-:d:682268
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    References listed on IDEAS

    as
    1. Nkiruka D Eze & Céu Mateus & Tiago Cravo Oliveira Hashiguchi, 2020. "Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-24, August.
    2. Sarah J Iribarren & Kenrick Cato & Louise Falzon & Patricia W Stone, 2017. "What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-20, February.
    3. Matthew Berman & Andrea Fenaughty, 2005. "Technology and managed care: patient benefits of telemedicine in a rural health care network," Health Economics, John Wiley & Sons, Ltd., vol. 14(6), pages 559-573, June.
    4. Antonio Lopez-Villegas & Daniel Catalan-Matamoros & Salvador Peiro & Knut Tore Lappegard & Remedios Lopez-Liria, 2020. "Cost–utility analysis of telemonitoring versus conventional hospital-based follow-up of patients with pacemakers. The NORDLAND randomized clinical trial," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-17, January.
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