|Opis:||Purpose: When treating a patient with a suspected arrhythmia at family medicine office, despite the great advances in medicine in this field, the patient is often referred to a cardiologist. In the times of the digital age, new technologies have emerged that offer remote services, which has proven to be very important in times of emergency as the current Covid-19 pandemic. The Jožef Štefan Institute, in collaboration with doctors, has developed a personal portable ECG sensor Savvy that works in combination with a smartphone and can be used in patients who complain about heart rhythm disorders. The studies showed that the use of similar sensors can significantly influence the quality of treatment of the patient at the primary level.
Goals: The goal was to analyse the usefulness of telecardiology in the primary health care level. With the help of a patient's history of rhythm disturbance and an ECG scan using an ECG personal sensor (ECG PS), we wanted to evaluate the satisfaction of patients and their physicians with the use of an ECG sensor treatment at the primary level. We also wanted to evaluate the cost-effectiveness of this tool at the primary level and propose a clinical pathway for treating patients with rhythm disorders at the primary health care level.
Methods: We have conducted an intervention randomized controlled trial, using a quantitative scientific methodology. We included patients (n=400) and their treating physicians (n=30) who visited a family medicine clinic in the period from October 2016 to January 2018 and compalined about for cardiac arrhythmias; patients were randomly divided in a test and control group. In the test group, the patient received a Savvy ECG sensor, and in the control group, an ECG sensor was not installed. After a check-up at the doctor in 5 to 10 days and in three months, we were able to raise or disprove the suspicion of a heart rhythm disorder, review the interventions that were necessary; we were mainly interested in the number of patients referred to a cardiologist and the satisfaction of patients and doctors with the method used.
Results: The patients included were on average 49,7 years old, three-quarters were women. There were no differences between the groups in the detected arrhythmias (26,0 vs. 32,0%, p=0,186), while when using the ECG meter, referrals to a cardiologist were statistically significantly less than in the control group (11,5 vs. 34,0 %, p |