Role of patient education in the perception and acceptance of home monitoring after recent implantation of cardioverter defibrillators: The EDUCAT study

Background. - Much attention is being paid to the education of and provision of medical information to patients, to optimize their understanding and acceptance of their disease. Aims. - To ascertain the impact of educating recent recipients of an implantable cardioverter defibrillator (ICD) on their perception and acceptance of a home monitoring (HM) system. Methods. - Questionnaire 1, completed one month after ICD implantation, was designed to assess: the quality of patient preparation for HM; patient comprehension of HM; and patient anxiety experienced during its installation. The comprehension questions were assigned a score of 2 for an incorrect answer, +1 for a correct answer and 0 for neither (total score ranging from 40 to +20). Questionnaire 2, completed six months after ICD implantation, assessed patient acceptance of and anxiety about HM. Results. - The registry included 571 patients (mean age 63.9 +/- 12.8 years; 83% men; 76% of ICDs implanted for primary prevention) followed by HM for 6.2 +/- 1.2 months. Questionnaire 1 was completed by 430 (75.3%) patients and questionnaire 2 by 398 (69.7%) patients. Younger patients had a better comprehension of HM than older patients. High-quality training conditions improved the comprehension score, and a positive association was observed between anxiety and acceptance levels and the comprehension score. The 80 +/- 20% mean data transmission rate (days of transmission/days of follow-up ratio) was unrelated to the comprehension scores. Conclusion. - A clear understanding was associated with a higher acceptance of HM, although it was unrelated to the data transmission rate. (C) 2014 Elsevier Masson SAS. All rights reserved.