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| Autori principali: | , , , , |
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| Natura: | Artículo Open Access |
| Pubblicazione: |
Wiley
2024
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| Accesso online: | https://onlinelibrary.wiley.com/doi/10.1111/pace.14912 |
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- Informational letters or postcards to initiate remote monitoring among veterans with pacemakers and implantable cardioverter‐defibrillators: A randomized, controlled trial Allison Kratka Thomas L. Rotering Merritt H. Raitt Mary A. Whooley Sanket S. Dhruva Pacing and Clinical Electrophysiology Abstract Background Remote monitoring (RM) of pacemakers and implantable cardioverter‐defibrillators (ICDs) is a Class 1, Level of Evidence A recommendation because of its multitude of clinical benefits. However, RM adherence rates are suboptimal, precluding patients from achieving these benefits. There is a need for direct‐to‐patient efforts to improve adherence. Methods In this national randomized, controlled trial conducted in the Veterans Health Administration (VHA), 2120 patients with a pacemaker or ICD who had not sent an RM transmission for ≥1 year (and usually ≥3 years) while under VHA care for their device were randomly assigned to be mailed a postcard ( n = 1076) or a detailed letter ( n = 1044). The postcard described what RM does and its key benefits (reduced mortality and fewer in‐person visits). The letter provided a similar message but included more details about RM benefits and the process. The primary outcome was an RM transmission sent within 90 days of mailing, and a secondary outcome was an RM transmission sent within 365 days. Results The primary outcome was achieved in 121 (11.3%) in the postcard and 96 patients (9.2%) in the letter group ( p = .12). The secondary outcome was achieved in 266 (24.7%) and 239 (22.9%), respectively ( p = .32). Conclusions This randomized trial showed no significant difference in the proportion of chronically non‐adherent patients who sent an RM transmission after receiving a low‐cost postcard or a detailed, higher‐cost letter encouraging their participation in RM. However, as only a minority of patients responded to either, further work is needed to engage patients in the life‐saving benefits of RM. 10.1111/pace.14912 http://onlinelibrary.wiley.com/termsAndConditions#vor