Implantable cardioverter defibrillator specific rehabilitation improves health cost outcomes: Findings from the COPE-ICD randomized controlled trial

TY - JOUR

T1 - Implantable cardioverter defibrillator specific rehabilitation improves health cost outcomes

T2 - Findings from the COPE-ICD randomized controlled trial

AU - Berg, Selina Kikkenborg

AU - Zwisler, Ann-Dorthe

AU - Koch, Mette Bjerrum

AU - Svendsen, Jesper Hastrup

AU - Christensen, Anne Vinggaard

AU - Pedersen, Preben Ulrich

AU - Thygesen, Lau Caspar

PY - 2015/3/1

Y1 - 2015/3/1

N2 - OBJECTIVE: The Copenhagen Outpatient ProgrammE - implantable cardioverter defibrillator (COPE-ICD) trial included patients with implantable cardioverter defibrillators in a randomized controlled trial of rehabilitation. After 6-12 months significant differences were found in favour of the rehabilitation group for exercise capacity, general and mental health. The aim of this paper is to explore the long-term health effects and cost implications associated with the rehabilitation programme; more specifically, (i) to compare implantable cardioverter defibrillator therapy history and mortality between rehabilitation and usual care groups; (ii) to examine the difference between rehabilitation and usual care groups in terms of time to first admission; and (iii) to determine attributable direct costs.METHODS: Patients with first-time implantable cardioverter defibrillator implantation (n = 196) were randomized (1:1) to comprehensive cardiac rehabilitation or usual care. Outcomes were measured by implantable cardioverter defibrillator therapy history from patient records and national register follow-up on mortality, hospital admissions and costs.RESULTS: No significant differences were found after 3 years for implantable cardioverter defibrillator therapy or mortality between rehabilitation and usual care. Time to first admission did not differ. The cost of rehabilitation was 335 USD/276 Euro per patient enrolled in rehabilitation. The total attributable cost of rehabilitation after 3 years was -6,789 USD/-5,593 Euro in favour of rehabilitation.CONCLUSION: No long-term health outcome benefits were found for the rehabilitation programme. However, the rehabilitation programme resulted in a reduction in total attributable direct costs.

AB - OBJECTIVE: The Copenhagen Outpatient ProgrammE - implantable cardioverter defibrillator (COPE-ICD) trial included patients with implantable cardioverter defibrillators in a randomized controlled trial of rehabilitation. After 6-12 months significant differences were found in favour of the rehabilitation group for exercise capacity, general and mental health. The aim of this paper is to explore the long-term health effects and cost implications associated with the rehabilitation programme; more specifically, (i) to compare implantable cardioverter defibrillator therapy history and mortality between rehabilitation and usual care groups; (ii) to examine the difference between rehabilitation and usual care groups in terms of time to first admission; and (iii) to determine attributable direct costs.METHODS: Patients with first-time implantable cardioverter defibrillator implantation (n = 196) were randomized (1:1) to comprehensive cardiac rehabilitation or usual care. Outcomes were measured by implantable cardioverter defibrillator therapy history from patient records and national register follow-up on mortality, hospital admissions and costs.RESULTS: No significant differences were found after 3 years for implantable cardioverter defibrillator therapy or mortality between rehabilitation and usual care. Time to first admission did not differ. The cost of rehabilitation was 335 USD/276 Euro per patient enrolled in rehabilitation. The total attributable cost of rehabilitation after 3 years was -6,789 USD/-5,593 Euro in favour of rehabilitation.CONCLUSION: No long-term health outcome benefits were found for the rehabilitation programme. However, the rehabilitation programme resulted in a reduction in total attributable direct costs.

KW - Adolescent

KW - Aged

KW - Aged, 80 and over

KW - Arrhythmias, Cardiac

KW - Defibrillators, Implantable

KW - Denmark

KW - Exercise Therapy

KW - Female

KW - Health Care Costs

KW - Hospitalization

KW - Humans

KW - Male

KW - Middle Aged

KW - Young Adult

U2 - 10.2340/16501977-1920

DO - 10.2340/16501977-1920

M3 - Journal article

C2 - 25437827

SN - 1650-1977

VL - 47

SP - 267

EP - 272

JO - Journal of Rehabilitation Medicine

JF - Journal of Rehabilitation Medicine

IS - 3

ER -