What is the clinical evidence from this study?

Study design: Observational. Population: Bradycardia requiring pacemaker implantation (n=1228). Intervention: Internal audit of pacemaker prescription vs. Pre-audit period. Primary outcome: Physiological pacing for atrioventricular block.

What does this research mean for the field?

Internal clinical audit improves adherence to physiological pacing guidelines for atrioventricular block, markedly increasing the adoption of physiological pacing systems while substantially raising hardware costs. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

April 1, 1994HeartOpen Access

Impact of internal audit on pacemaker prescription and the immediate costs of pacing in the northern region: towards implementation of the recommendations of the British Pacing and Electrophysiology Group.

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Key result

Internal pacemaker audit linked to a ~126% increase in physiological pacing for AV block, raising costs.

n=1,228

Why the study?

Does an internal audit improve adherence to physiological pacing guidelines and what is its impact on hardware costs?

Population

1,228 patients who underwent first pacemaker implantation at the Freeman Hospital between March 1990 and…

Comparison

Internal audit of pacemaker prescription… vs Pacemaker prescription practices prior to the…

Design

Cohort

Authors

JMJ. P. D. MounseyUniversity of North Carolina at Chapel Hill SRSimon RayGeneral Cardiology MGMichael GriffithBaystate Medical Center

Discussion

Member takes

Implication

Internal audit was associated with higher physiological pacing uptake; leaves open whether added hardware costs are justified by outcomes.

Study Design

Type

Observational (n=1,228)

Multicenter

Structured PICO

Does an internal audit improve adherence to physiological pacing guidelines and what is its impact on hardware costs?

Population

1,228 patients who underwent first pacemaker implantation at a single center between March 1990 and February 1993, audited retrospectively.

Exposure

Internal audit of pacemaker prescription practices based on the recommendations of the British Pacing and Electrophysiology Group (September 1991 to February 1993).

Comparator

Pacemaker prescription practices prior to the internal audit (March 1990 to August 1991).

Outcome

Changes in pacemaker prescription (pacing mode) and costs of generator and leads.

Main Result

Absolute Event Rate: 54.2% vs 24%

An internal audit successfully increased adherence to physiological pacing guidelines for atrioventricular block, though this resulted in a substantial increase in hardware costs.

Cite This Study

Mounsey et al. (1994) conducted an observational in Bradycardia requiring pacemaker implantation (n=1,228). Internal audit of pacemaker prescription vs. Pre-audit period was evaluated on Physiological pacing for atrioventricular block. An internal audit of pacemaker prescriptions was followed by an increase in physiological pacing for atrioventricular block from 24.0% to 54.2%, leading to increased hardware costs.

synapsesocial.com/papers/6aa7dbe0eb815e3469da0e51 https://doi.org/10.1136/hrt.71.4.395

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Implication

Internal audit was associated with higher physiological pacing uptake; leaves open whether added hardware costs are justified by outcomes.

Impact of internal audit on pacemaker prescription and the immediate costs of pacing in the northern region: towards implementation of the recommendations of the British Pacing and Electrophysiology Group.

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Impact of internal audit on pacemaker prescription and the immediate costs of pacing in the northern region: towards implementation of the recommendations of the British Pacing and Electrophysiology Group.

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider