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Advisor(s)
Abstract(s)
Introdução: A consulta remota de dispositivos cardíacos implantáveis revela-se atualmente uma
opção promissora de follow-up dos pacientes, com impacto nos ganhos em saúde.
Objetivo: Realizar uma análise comparativa dos ganhos em saúde na consulta remota versus
consulta presencial avaliando qual a modalidade mais eficiente, eficaz e segura na prestação de
cuidados de saúde.
Metodologia: Analisaram-se retrospetivamente 157 pacientes selecionados aleatoriamente no
período compreendido entre Janeiro de 2011 e Dezembro de 2013, agrupados de acordo com
a modalidade de consulta: consulta presencial (CP) e consulta remota (CR). Compararam-se as
seguintes variáveis: número de consultas efetuadas; número de consultas presenciais não
programadas; incidência e tempo médio de deteção de eventos, número de choques
inapropriados, número e períodos médios de reinternamento bem como número de idas ao
serviço de urgência. Os dados foram obtidos consultando os processos clínicos dos pacientes e
plataformas informáticas: Glintt®; SClinic® e Medtronic CarelinK Network®.
Resultados: Dos 157 pacientes, 67 pertenciam ao grupo da CP (idade média±dp de
64,75±14,90, 67% indivíduos do género masculino) e 90 ao grupo da CR (idade média±dp de
59±14,40 com 87% indivíduos do género masculino). Dos resultados obtidos verificaram-se
diferenças estatisticamente significativas nas variáveis: número de consultas efetivadas
(p<0,001), número de consultas presenciais não programadas (p<0,001), tempo médio de
deteção de eventos (p=0,002) bem como número de choques inapropriados (p=0,002), onde se
verificou que a CR permitia realizar um maior número de consultas, diminuindo o número de
consultas presenciais não programadas e choques inapropriados bem como o tempo médio de
deteção de eventos. Não se verificaram diferenças estatisticamente significativas nas restantes
variáveis analisadas.
Conclusão: A consulta remota revelou-se uma opção tecnicamente eficaz, segura e eficiente
que potencia uma melhoria na qualidade dos cuidados de saúde prestados sem comprometer a
condição clínica dos pacientes.
Introduction: The remote follow-up of implantable cardiac devices currently proves to be a promising option of follow-up of patients, with impact on health gains. Objective: Perform a comparative analysis of health gains in the remote follow-up versus inoffice visits to evaluate which modality is the more efficient, effective and safe. Methods: We analyzed retrospectively 157 patients randomly selected from the period between January 2011 and December 2013, grouped according to the type of consultation: in-office visits and remote follow-up. We compared the following variables: number of follow-up carried out; number of unscheduled in-office visits; incidence and average time of event detection, number of inappropriate shocks, number and average periods of hospitalizations as well as number of trips to the emergency room. Data were obtained from the medical records of patients and computer platforms : Glintt® ; SClinic® ; Medtronic CareLink Network® . Results: Of 157 patients, 67 belonged to the in-office group (mean age±SD of 64.75±14.90, 67% male subjects) and 90 to the remote group (mean age±SD of 59±14.40 with 87% of male subjects). The results obtained demonstrated that there were statistically significant differences in the following variables: number of consultations carried out (p<0.001), number of unscheduled in-office visits (p<0.001), mean time event detection (p=0.002) and number of inappropriate shocks (p=0.002), which showed that the remote follow-up makes it possible to achieve a greater number of queries, reducing the number of unscheduled in-office visits and inappropriate shocks and the average time event detection. There were no statistically significant differences in other variables. Conclusion: Remote follow-up proved to be a technically effective and safe option that enhances an improvement in the quality of health care without compromising the clinical condition of patients.
Introduction: The remote follow-up of implantable cardiac devices currently proves to be a promising option of follow-up of patients, with impact on health gains. Objective: Perform a comparative analysis of health gains in the remote follow-up versus inoffice visits to evaluate which modality is the more efficient, effective and safe. Methods: We analyzed retrospectively 157 patients randomly selected from the period between January 2011 and December 2013, grouped according to the type of consultation: in-office visits and remote follow-up. We compared the following variables: number of follow-up carried out; number of unscheduled in-office visits; incidence and average time of event detection, number of inappropriate shocks, number and average periods of hospitalizations as well as number of trips to the emergency room. Data were obtained from the medical records of patients and computer platforms : Glintt® ; SClinic® ; Medtronic CareLink Network® . Results: Of 157 patients, 67 belonged to the in-office group (mean age±SD of 64.75±14.90, 67% male subjects) and 90 to the remote group (mean age±SD of 59±14.40 with 87% of male subjects). The results obtained demonstrated that there were statistically significant differences in the following variables: number of consultations carried out (p<0.001), number of unscheduled in-office visits (p<0.001), mean time event detection (p=0.002) and number of inappropriate shocks (p=0.002), which showed that the remote follow-up makes it possible to achieve a greater number of queries, reducing the number of unscheduled in-office visits and inappropriate shocks and the average time event detection. There were no statistically significant differences in other variables. Conclusion: Remote follow-up proved to be a technically effective and safe option that enhances an improvement in the quality of health care without compromising the clinical condition of patients.
Description
Keywords
Cardiodesfibriladores implantáveis consulta remota ganhos em saúde implantable cardioverter-defibrillator health gains remote follow-up