Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
J Med Internet Res. 2022 Apr 25;24(4):e30236. doi: 10.2196/30236.
Smartphone compatible wearables have been released on the consumers market, enabling remote monitoring. Remote monitoring is often named as a tool to reduce the cost of care.
The primary purpose of this paper is to describe a cost-utility analysis of an eHealth intervention compared to regular follow-up in patients with acute myocardial infarction (AMI).
In this trial, of which clinical results have been published previously, patients with an AMI were randomized in a 1:1 fashion between an eHealth intervention and regular follow-up. The remote monitoring intervention consisted of a blood pressure monitor, weight scale, electrocardiogram device, and step counter. Furthermore, two in-office outpatient clinic visits were replaced by e-visits. The control group received regular care. The differences in mean costs and quality of life per patient between both groups during one-year follow-up were calculated.
Mean costs per patient were €2417±2043 (US $2657±2246) for the intervention and €2888±2961 (US $3175±3255) for the control group. This yielded a cost reduction of €471 (US $518) per patient. This difference was not statistically significant (95% CI -€275 to €1217; P=.22, US $-302 to $1338). The average quality-adjusted life years in the first year of follow-up was 0.74 for the intervention group and 0.69 for the control (difference -0.05, 95% CI -0.09 to -0.01; P=.01).
eHealth in the outpatient clinic setting for patients who suffered from AMI is likely to be cost-effective compared to regular follow-up. Further research should be done to corroborate these findings in other patient populations and different care settings.
ClinicalTrials.gov NCT02976376; https://clinicaltrials.gov/ct2/show/NCT02976376.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/resprot.8038.
智能手机兼容的可穿戴设备已在消费者市场上发布，实现了远程监控。远程监控通常被视为降低护理成本的工具。
本文的主要目的是描述电子健康干预措施与急性心肌梗死（AMI）患者常规随访相比的成本效用分析。
在这项试验中，先前已发表了其临床结果，AMI 患者以 1:1 的比例随机分配到电子健康干预组和常规随访组。远程监测干预包括血压计、体重秤、心电图仪和计步器。此外，两次门诊就诊被电子就诊取代。对照组接受常规护理。在一年的随访期间，计算两组患者的平均成本和生活质量差异。
干预组每位患者的平均费用为 2417±2043 欧元（2657±2246 美元），对照组为 2888±2961 欧元（3175±3255 美元）。这使得每位患者的成本降低了 471 欧元（518 美元）。差异无统计学意义（95%CI-€275 至 €1217；P=.22，美元-302 至 1338）。干预组第一年平均调整生命年为 0.74，对照组为 0.69（差值-0.05，95%CI-0.09 至 -0.01；P=.01）。
在门诊环境中为 AMI 患者提供电子健康服务可能比常规随访更具成本效益。应进一步研究以在其他患者人群和不同护理环境中证实这些发现。
ClinicalTrials.gov NCT02976376；https://clinicaltrials.gov/ct2/show/NCT02976376。
国际注册报告标识符（IRRID）：RR2-10.2196/resprot.8038。
