@Article{info:doi/10.2196/30236,
author="Treskes, Roderick Willem
and van den Akker-van Marle, M Elske
and van Winden, Louise
and van Keulen, Nicole
and van der Velde, Enno Tjeerd
and Beeres, Saskia
and Atsma, Douwe
and Schalij, Martin Jan",
title="The Box---eHealth in the Outpatient Clinic Follow-up of Patients With Acute Myocardial Infarction: Cost-Utility Analysis",
journal="J Med Internet Res",
year="2022",
month="Apr",
day="25",
volume="24",
number="4",
pages="e30236",
keywords="smart technology; myocardial infarction; cost-utility; outpatients; cost-effectiveness; eHealth; remote monitoring; cost of care; quality of life",
abstract="Background: Smartphone compatible wearables have been released on the consumers market, enabling remote monitoring. Remote monitoring is often named as a tool to reduce the cost of care. Objective: The primary purpose of this paper is to describe a cost-utility analysis of an eHealth intervention compared to regular follow-up in patients with acute myocardial infarction (AMI). Methods: In this trial, of which clinical results have been published previously, patients with an AMI were randomized in a 1:1 fashion between an eHealth intervention and regular follow-up. The remote monitoring intervention consisted of a blood pressure monitor, weight scale, electrocardiogram device, and step counter. Furthermore, two in-office outpatient clinic visits were replaced by e-visits. The control group received regular care. The differences in mean costs and quality of life per patient between both groups during one-year follow-up were calculated. Results: Mean costs per patient were {\texteuro}2417{\textpm}2043 (US {\$}2657{\textpm}2246) for the intervention and {\texteuro}2888{\textpm}2961 (US {\$}3175{\textpm}3255) for the control group. This yielded a cost reduction of {\texteuro}471 (US {\$}518) per patient. This difference was not statistically significant (95{\%} CI --{\texteuro}275 to {\texteuro}1217; P=.22, US {\$}--302 to {\$}1338). The average quality-adjusted life years in the first year of follow-up was 0.74 for the intervention group and 0.69 for the control (difference --0.05, 95{\%} CI --0.09 to --0.01; P=.01). Conclusions: eHealth in the outpatient clinic setting for patients who suffered from AMI is likely to be cost-effective compared to regular follow-up. Further research should be done to corroborate these findings in other patient populations and different care settings. Trial Registration: ClinicalTrials.gov NCT02976376; https://clinicaltrials.gov/ct2/show/NCT02976376 International Registered Report Identifier (IRRID): RR2-10.2196/resprot.8038 ",
issn="1438-8871",
doi="10.2196/30236",
url="https://www.jmir.org/2022/4/e30236",
url="https://doi.org/10.2196/30236",
url="http://www.ncbi.nlm.nih.gov/pubmed/35468091"
}