Key result
Remote monitoring of cardiac devices in Italy increasingly utilized a primary nursing model, with transmissions submitted to physicians only in critical cases rising from 28.3% to 64.3% (P<0.001).
Why the study?
The study evaluated the use of remote monitoring in Italian clinical practice and its trend over a 5-year period.
How has the use and organization of remote monitoring for cardiac implantable electronic devices changed in Italian clinical practice between 2012 and 2017?
Observational (n=240)
Yes
How has the use and organization of remote monitoring for cardiac implantable electronic devices changed in Italian clinical practice between 2012 and 2017?
Absolute Event Rate: 64.3% vs 28.3%
p-value: p=<0.001
The use of remote monitoring for cardiac implantable electronic devices in Italy has increased significantly over 5 years, increasingly managed through a primary nursing model, though lack of reimbursement remains a major barrier.
Supports shift toward nurse-led remote monitoring models; leaves open reimbursement barriers and outcome effects in broader practice.
AIMS: The aim of this study was to evaluate the use of remote monitoring in Italian clinical practice and its trend over the last 5 years. METHODS: In 2012 and 2017, two surveys were conducted. Both were open to all Italian implanting centres and consisted of 25 questions on the characteristics of the centre, their actual use of remote monitoring, applied organizational models and administrative and legal aspects. RESULTS: The questionnaires were completed by 132 and 108 centres in 2012 and 2017, respectively (30.6 and 24.7% of all Italian implanting centres). In 2017, significantly fewer centres followed up fewer than 200 patients by remote monitoring than in 2012, while more followed up more than 500 patients (all P < 0.005). In most of the centres (77.6%) that responded to both surveys, the number of patients remotely monitored significantly increased from 2012 to 2017.In both surveys, remote monitoring was usually managed by physicians and nurses. Over the period, primary review of transmissions by physicians declined, while it was increasingly performed by nurses; the involvement of technicians rose, while that of manufacturers' technical personnel decreased. The percentage of centres in which transmissions were submitted to the physician only in critical cases rose (from 28.3 to 64.3%; P < 0.001). In 86.7% of centres, the lack of a reimbursement system was deemed the main barrier to implementing remote monitoring. CONCLUSION: In the last 5 years, the number of patients followed up by remote monitoring has increased markedly. In most Italian centres, remote monitoring has increasingly been managed through a primary nursing model. The lack of a specific reimbursement system is perceived as the main barrier to implementing remote monitoring .
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Palmisano et al. (2020) conducted an observational in Cardiac implantable electronic devices (n=240). Remote monitoring practices (2017) vs. Remote monitoring practices (2012) was evaluated on Centres submitting transmissions to the physician only in critical cases (p=<0.001). Remote monitoring of cardiac devices in Italy increasingly utilized a primary nursing model, with transmissions submitted to physicians only in critical cases rising from 28.3% to 64.3% (P<0.001).
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