Remote Monitoring Reduces Expenditures Associated with Implantable Cardioverter Defibrillators

MedicalResearch.com Interview with:

Joseph A. Ladapo, MD, PhD Assistant Professor of Medicine Section on Value and Effectiveness Department of Population Health NYU School of Medicine

Dr. Joseph Ladapo

Joseph A. Ladapo, MD, PhD
Assistant Professor of Medicine and Population Health
Section on Value and Effectiveness
Department of Population Health
NYU Langone School of Medicine
New York NY 10016

MedicalResearch.com: What are the main findings?

Dr. Ladapo: While cardiac implantable electronic devices (CIEDs) are increasingly used to treat patients with arrhythmias, heart failure, and other risk factors for sudden cardiac death, these implantable devices require life-long follow-up to assess their performance and functionality. This need for continuous monitoring has galvanized the development of remote monitoring technologies for patients with CIEDs. Although randomized studies have shown that remote monitoring may reduce healthcare utilization and expenditures when compared to in-office monitoring, little is known about whether these findings generalize to day-to-day clinical practice. We aimed to address this uncertainty by evaluating healthcare utilization and expenditures in a cohort of patients with newly-implanted CIEDs who were followed remotely or with in-office monitoring.

MedicalResearch.com: What is the background for this study?

Dr. Ladapo: Remote monitoring is associated with a reduction in patients’ utilization of ambulatory and acute care and a reduction in expenditures associated with this utilization—at least over 24 months. This reduction was most pronounced among remotely monitored patients with implantable cardioverter defibrillators (ICDs).  Although many of our comparisons between remote and office monitoring were not statistically significant, they trended toward favoring remote monitoring.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Ladapo: Our results support the notion that remote monitoring may help reduce ED visits and hospitalizations, leading to substantial cost savings. This is an exciting finding for patients and for the healthcare system.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Ladapo: We need to better understand how to optimize remote monitoring systems to further reduce healthcare costs, and we need to understand the potential cost implications of advancements in remote monitoring technology. 

MedicalResearch.com: Is there anything else you would like to add?

Dr. Ladapo: Studies like ours are important for the translation of economic findings in clinical trials to actual day-to-day clinical practice. Randomized trials routinely enroll highly-selected patients, and their findings may not generalize to the wider population of patients. Analyses that use large observational datasets and employ methods to reduce bias and confounding, as we did, can help address concerns about the generalizability of clinical trial findings.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Health Care Utilization and Expenditures Associated With Remote Monitoring in Patients With Implantable Cardiac Devices

Ladapo, Joseph A. et al.
American Journal of Cardiology , Volume 0 , Issue 0 ,
DOI: http://dx.doi.org/10.1016/j.amjcard.2016.02.015

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Published Online:February 16, 2016

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Joseph A. Ladapo, MD, PhD (2016). Remote Monitoring Reduces Expenditures Associated with Implantable Cardioverter Defibrillators MedicalResearch.com

Last Updated on April 7, 2016 by Marie Benz MD FAAD