In the last decade a limited number of studies have shown results on efficiency particularly based on patient-reported outcomes such as HRQoL. In addition, the number of unscheduled visits to the hospital for assistance at the emergency services and hospitalizations can be reduced. Along last decade, several studies have showed that TM is as effective as traditional follow-up in hospital. TM may be a potential alternative to help reduce the number of in-office visits to hospital, thereby optimizing medical resources. Remote monitoring or tele-monitoring (TM) systems have potential advantages such as early detection of cardiovascular events and early response to technical problems of the device or changes in the patient’s clinical status. The routine follow-up is thus a heavy burden for the respective national health services as well as for the pacemakers users and their caregivers. With an ageing population and widening indications for PM implantation, the number of persons carrying an implant is steadily increasing. Every hospital visit usually involves an assessment of pacemakers function, cardiovascular events and an analysis of patient physical status and, whether is necessary the medication is modified and/or the device is re-configured again. International guidelines of professional practice advises that users with pacemakers (PM) must be monitored in periods between 3 and 12 months. In addition, provides a scientifically rigorous method to the field of HRQoL evaluations in patients with pacemakers. Without significant differences with regards to effectiveness and safety. The NORDLAND trial shows that HRQoL is improved after implant in both groups. The number of in-office visits was similar in both groups (TM: 1.24 vs HM: 1.12 P = 0.30). The MLHFQ score was improved in both groups (TM: -4.40 HM: -15.13 p < 0.001). At the 6 month follow-up, there were no significant differences between the groups in EQ-5D utilities (TM: 0.81 HM: 0.76 p = 0.54) and EQ-5D VAS scores (TM: 72.71 HM: 59.79 p = 0.08). Baseline characteristics and number of hospital visits were also analyzed. The EuroQol-5D (EQ-5D) utilities and visual analogue scale (VAS) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) were used to measure Health-Related Quality of Life. Between August of 2014 and November of 2015, 50 patients were assigned to either a tele-monitoring group ( n = 25) or a conventional hospital monitoring (HM) group ( n = 25). The NORDLAND study is a controlled, randomized, non-masked clinical trial in pacemaker patients, with data collection carried out during the pre-implant stage and after 6 months. The aim of this study was to assess the effectiveness of tele-monitoring (TM) in patients with pacemakers regarding reliability, safety and health-related quality of life, compared to traditional follow-up in outpatient clinic in a setting where geographical effects could possible influence the results. It is thus unknown whether these results could be applied also in rural areas such as Northern Norway with a more scattered population. Most of them of the studies have been performed in densely populated areas and nearby to the hospital. The routine follow-up is thus a heavy burden for the respective NHS as well as for the patients and their relatives. With an ageing population and widening indications for pacemakers implantation, the number of persons carrying an implant is steadily increasing.
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