Key result
Phone-call outreach cuts annual follow-up noncompliance to ~5% in pediatric CIED patients.
Why the study?
Patient compliance with in-clinic visits and remote transmissions for pediatric patients with CIEDs is poor, necessitating assessment and optimization of follow-up.
Do targeted interventions (phone calls, texts/emails) improve follow-up compliance in pediatric patients with CIEDs?
Do targeted interventions (phone calls, texts/emails) improve follow-up compliance in pediatric patients with CIEDs?
Personal phone calls are significantly more effective than automated messaging at improving follow-up compliance in pediatric patients with CIEDs.
May support personal phone calls to improve pediatric CIED follow-up compliance; leaves open causality and generalizability to other interventions.
BACKGROUND: The use of cardiac implantable electronic devices (CIEDs) continues to grow. Despite the presence of implanted hardware, patient compliance with in-clinic visits and remote transmissions is poor. We performed a quality improvement (QI) initiative to assess and optimize CIED follow-up in the New England area. METHODS: A regional network of eight pediatric institutions was created. All patients with CIEDs were identified starting in 2016. Noncompliance was defined as: no in-person evaluation within 1 year, or no remote transmission within 6 months. Interventions performed included automated texts/emails, certified letters, and personal phone calls. RESULTS: A total of 612 patients were identified, with the total number of patients increasing over the 5-year QI period as patients had devices implanted and removed. Initial noncompliance with in-person annual follow-up was 29%. If patients were noncompliant, a personal phone call was made, reminding them to return to clinic. If the patient could not be reached for 3 months, a certified letter was sent. The noncompliance rate decreased to 5% over the first year and remained around this level over the QI period (3%-9%). For remote transmissions, 54% of patients were noncompliant. Interventions were performed on subgroups of patients. Automated texts/emails were trialed in 126; after 6 months, 41% of these patients remained noncompliant. Phone calls were then trialed on 87 patients. Over 6 months, noncompliance decreased to 11%. CONCLUSIONS: Patients with CIEDs have poor compliance with regular follow-up. Patients have a limited response to automated measures (texts/emails). Personal phone calls had the greatest impact in improving compliance.
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Schefter et al. (2025) studied Pediatric patients with cardiovascular implantable electronic devices (n=612). Quality improvement initiative (automated texts/emails, certified letters, and personal phone calls) vs. Baseline (pre-intervention) was evaluated on Noncompliance with in-person annual follow-up. A quality improvement initiative utilizing personal phone calls reduced noncompliance with in-person annual follow-up from 29% to 5% among pediatric patients with CIEDs.
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