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Remote monitoring and clinical outcomes: details on information flow and workflow in the IN-TIME study

D. Husser, J. Christoph Geller, M. Taborsky, R. Schomburg, F. Bode, JC. Nielsen, C. Stellbrink, C. Meincke, SP. Hjortshøj, J. Schrader, T. Lewalter, G. Hindricks,

. 2019 ; 5 (2) : 136-144. [pub] 20190401

Language English Country England, Great Britain

Document type Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc19028318
E-resources Online Full text

NLK ProQuest Central from 2016-10-01 to 1 year ago
Health & Medicine (ProQuest) from 2016-10-01 to 1 year ago

Links

PubMed 30016396
DOI 10.1093/ehjqcco/qcy031
Knihovny.cz E-resources

AIMS: Randomized clinical trials investigating a possible outcome effect of remote monitoring in patients with implantable defibrillators have shown conflicting results. This study analyses the information flow and workflow details from the IN-TIME study and discusses whether differences of message content, information speed and completeness, and workflow may contribute to the heterogeneous results. METHODS AND RESULTS: IN-TIME randomized 664 patients with an implantable cardioverter/defibrillator indication to daily remote monitoring vs. control. After 12 months, a composite clinical score and all-cause mortality were improved in the remote monitoring arm. Messages were received on 83.1% of out-of-hospital days. Daily transmissions were interrupted 2.3 times per patient-year for more than 3 days. During 1 year, absolute transmission success declined by 3.3%. Information on medical events was available after 1 day (3 days) in 83.1% (94.3%) of the cases. On all working days, a central monitoring unit informed investigators of protocol defined events. Investigators contacted patients with a median delay of 1 day and arranged follow-ups, the majority of which took place within 1 week of the event being available. CONCLUSION: Only limited data on the information flow and workflow have been published from other studies which failed to improve outcome. However, a comparison of those data to IN-TIME suggest that the ability to see a patient early after clinical events may be inferior to the set-up in IN-TIME. These differences may be responsible for the heterogeneity found in clinical effectiveness of remote monitoring concepts.

References provided by Crossref.org

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$a Nielsen, Jens Cosedis $u Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark.
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$a Lewalter, Thorsten $u Peter Osypka Heart Center, Am Isarkanal 36, München, Germany.
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