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Patient knowledge of implantable devices suboptimal
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SAN FRANCISCO — Most patients missed at least one question on basic information about their implantable cardiac device, and almost half missed at least two questions, according to survey results presented at the Heart Rhythm Society Annual Scientific Sessions.
Divyang R. Patel, MD, cardiology fellow at Cleveland Clinic, and colleagues administered the survey to 344 patients (mean age, 63 years; 64% men) who presented to the clinic for a device interrogation between July and December 2018.
The survey, consisting of seven multiple-choice questions, asked patients to identify the type of device they had, original indication, functionality, manufacturer, number of active leads, estimated battery life and number of shocks. Patients were also asked what kind of data they wanted to be aware of from their devices.
“We live in an era where patients have access to their medical records and to consumer products with diagnostic tools,” Khaldoun G. Tarakji, MD, MPH, associate head of cardiac electrophysiology and pacing in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at Cleveland Clinic’s Sydell and Arnold Miller Family Heart & Vascular Institute, and senior investigator, said in an interview. “It is a no-brainer that they want to know about a device that may have been implanted in them for years. The question is, how much do they think they know and how much do they actually know? This is relevant to how pacemakers and defibrillators are monitored today. Nowadays, some devices can talk directly to smartphones, which transmit the data. It provides an opportunity for patients to have some visibility about the process.”
At baseline, 62% of patients said they agreed or strongly agreed that they were knowledgeable about their device.
However, according to the researchers, 84% of patients missed at least one question and 48% missed at least two.
The rates of correct responses were as follows: type of device, 75%; reason for implant, 75%; functions of the device, 70%; manufacturer, 91%; number of functional leads, 91%; estimated battery life, 59%; and number of shocks, 84%.
“Clearly, there is a gap between what patients think they know and what they actually do know,” Tarakji, a Cardiology Today Next Gen Innovator, said in an interview.
The types of data most commonly desired by patients included battery life (81%), activity level (76%), heart rate trend (73%) and ventricular arrhythmias (71%), according to the researchers.
“The language used in device interrogation has never been designed to be communicated to patients,” Tarakji told Cardiology Today. “It is also an eye-opener that what is important from the clinician’s perspective might not be the same from the patient’s perspective. For example, battery life is extremely important for patients and physicians, but the patients are also interested in activity level, whereas clinicians might be more interested in lead capture, sensing and impedance. We are trying to be aligned with and to be more transparent with our patients. We must design a plan where the data shared engage the patients but do not raise anxiety.” – by Erik Swain
Reference:
Patel DR, et al. Abstract S-BS03-06. Presented at: Heart Rhythm Society Annual Scientific Sessions; May 8-11, 2019; San Francisco.
Disclosures: Patel reports no relevant financial disclosures. Tarakji reports he is a consultant for AliveCor and Medtronic.