ICD, Pacemaker DDD, Adherence, Patient
Conditions
Brief summary
We tested the effect of informational postcards on improving remote monitoring adherence among Veterans with pacemakers and implantable cardioverter-defibrillators in a stepped-wedge randomized controlled trial.
Detailed description
Objective: To test the effect of informational postcards on remote monitoring adherence among Veterans with pacemakers and implantable cardioverter-defibrillators (ICDs). Design/Patients: Stepped-wedge randomized controlled trial among Veterans with pacemakers and ICDs. Intervention: In wave 1, Veterans who had sent at least 1 transmission within the past 2 years but had become non-adherent were randomly assigned to receive a postcard or no postcard. Those receiving postcards were randomized to 1 of 2 messages: 1) a warning postcard describing risks of non-adherence or 2) an encouraging postcard describing benefits of adherence. In wave 2, Veterans who had either not received a postcard in wave 1 or had since become non-adherent were mailed a postcard (again, randomized to 1 of 2 messages). Patients who did not send a remote monitoring transmission within 1 month were mailed a second, identical postcard. Main Measures: Proportion of patients who sent a transmission within 70 days.
Interventions
OTHERPostcard
Participants received a postcard asking them to address non-adherence to remote monitoring.
Sponsors
US Department of Veterans Affairs
Study design
Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Investigator)
Intervention model description
This was a stepped-wedge randomized controlled trial with two waves. In wave 1, Veterans who had sent at least 1 transmission within the past 2 years but had become non-adherent were randomly assigned to receive a postcard or no postcard. Those receiving postcards were randomized to 1 of 2 messages: 1) a warning postcard describing risks of non-adherence or 2) an encouraging postcard describing benefits of adherence. In wave 2, Veterans who had either not received a postcard in wave 1 or had since become non-adherent were mailed a postcard (again, randomized to 1 of 2 messages). Patients who did not send a RM transmission within 1 month were mailed a second, identical postcard.
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Veteran patients with wireless RM-capable pacemakers and ICDs followed by the VA National Cardiac Device Surveillance Program (VANCDSP) * Sent at least 1 remote transmission within the past 2 years but had become non-adherent (defined as missing their last scheduled transmission by at least 10 days)
Exclusion criteria
* Veteran patients without a wireless RM-capable device * Had not sent a remote transmission in the past 2 years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Remote monitoring transmission | 70 days | Proportion of patients who sent a transmission within 70 days |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Transmission after first postcard | 70 days | Proportion of patients who sent a transmission after the first postcard |
Countries
United States
Outcome results
None listed