Effectiveness of pacemaker tele-monitoring on quality of life, functional capacity, event detection and workload: The PONIENTE trial

Geriatr Gerontol Int. 2016 Nov;16(11):1188-1195. doi: 10.1111/ggi.12612. Epub 2015 Dec 4.

Abstract

Aims: The purpose of the present study was to assess the effectiveness of the remote monitoring (RM) of older adults with pacemakers on health-related quality of life, functional capacity, feasibility, reliability and safety.

Methods: The PONIENTE study is a controlled, non-randomized, non-blinded clinical trial, with data collection carried out during the pre-implant stage and after 12 months. Between October of 2012 and November of 2013, 82 patients were assigned to either a remote monitoring group (n = 30) or a conventional hospital monitoring (HM) group (n = 52). The EuroQol-5D (EQ-5D) and the Duke Activity Status Index were used to measure health-related quality of life and functional capacity, respectively. Baseline characteristics and number of hospital visits were also analyzed.

Results: The baseline characteristics of the two study groups were similar for both the EQ-5D (RM 0.74, HM 0.67; P = 0.404) and the Duke Activity Status Index (RM 21.42, HM 19.95; P = 0.272). At the 12-month follow up, the EQ-5D utility score was improved for both groups (RM 0.91, HM 0.81; P = 0.154), unlike the EQ-5D Visual Analog Scale (P = 0.043). The Duke Activity Status Index score was similar to the baseline score. The number of in-hospital visits was 27% lower (3 vs 4; P < 0.001) in the remote group as compared with the hospital group.

Conclusions: The PONIENTE trial suggests that the remote monitoring of pacemakers in older adults is an equivalent option to hospital monitoring, in terms of health-related quality of life and functional capacity. Furthermore, it allows for the early detection of clinical and pacemaker-related adverse events, and significantly reduces the number of in-hospital visits. Geriatr Gerontol Int 2016; 16: 1188-1195.

Keywords: older adults; pacemaker follow up; quality of life; remote monitoring; telemedicine.

Publication types

  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Cardiac Pacing, Artificial / methods
  • Cardiac Pacing, Artificial / trends
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / therapy*
  • Geriatric Assessment
  • Humans
  • Middle Aged
  • Monitoring, Physiologic / methods*
  • Pacemaker, Artificial / adverse effects
  • Pacemaker, Artificial / standards*
  • Patient Safety
  • Quality of Life*
  • Telemetry / methods*
  • Treatment Outcome
  • Workload