Knowledge Update on the Economic Evaluation of Pacemaker Telemonitoring Systems

Area of Science:

• Cardiology
• Health Informatics
• Health Economics

Background:

• Telemedicine, specifically telemonitoring (TM), has gained traction for pacemaker patient care.
• The COVID-19 pandemic accelerated the adoption of TM due to the need for reduced physical contact.
• Existing knowledge on the long-term effectiveness, costs, and health outcomes of TM versus conventional monitoring (CM) requires updating.

Purpose of the Study:

• To compare the medium- and long-term effectiveness of telemonitoring (TM) versus conventional monitoring (CM) for pacemaker patients.
• To evaluate the associated costs and health outcomes of both monitoring modalities.
• To update current knowledge on TM for pacemaker management.

Main Methods:

• A systematic literature search was conducted across PubMed, EMBASE, Scopus, and Google Scholar until July 2021.
• Included studies featured experimental or observational designs with complete economic evaluations.
• Studies compared telemonitoring (TM) with conventional monitoring (CM) in patients with implanted pacemakers.

Main Results:

• 11 studies with 3372 patients were included; 52.58% were from randomized clinical trials.
• Telemonitoring (TM) significantly reduced unscheduled hospital visits by 8.34-55.55% and lowered costs by up to 87%.
• No significant differences were found in health-related quality of life (HRQoL) or cardiovascular events between TM and CM.

Conclusions:

• Telemonitoring (TM) enables earlier detection and treatment of cardiovascular events in pacemaker patients.
• TM significantly decreases unscheduled hospital visits and reduces both formal and informal costs in the medium and long term.
• Telemonitoring (TM) does not adversely affect patients' health-related quality of life (HRQoL).