Cost-utility Analysis of Ambulatory Care Compared to Conventional Patient Care of Permanent Pacemakers Replacement for Elective Replacement Indicator

NCT ID: NCT03876600

Last Updated: 2019-03-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

750 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-04-30

Study Completion Date

2022-04-30

Brief Summary

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START study is a comparison of cost-utility between permanent pacemaker replacement ambulatory care and permanent pacemaker replacement conventional hospitalization care.

The hypothesis of the study is that ambulatory care compared to conventional hospitalization, involving a stay of more than 24 hours, would reduce hospitalization and care expenses without loss of quality of care and without increasing the complication rate for patients.

Detailed Description

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In France, nearly 49,000 permanent pacemakers are implanted each year. The pacemaker longevity is about 10 years which leads to their replacement.

In France, in 2016, 15,764 pacemaker replacement hospital stays took place. 10.6% of them were made during an outpatient stay, 12.4% during a one-night hospitalization and 70.7% during hospitalization for two or more than two nights for the severity level 1.

If the outpatient care management is deployed at 90%, the economy of the cost care will be estimated to be 3,5 million euros and a reduction of 15 582 hospitalization night's stay.

The aim of START study is to compare cost-utility between ambulatory and conventional hospitalization care of permanent pacemakers replacement for elective replacement indicator and to demonstrate equivalence between outpatient management and conventional hospitalization management.

This study is in adequation with the national ambition to deploy the outpatient management in France. Surgery is the same with both hospitalization managements.

An ambulatory surgery need to present different advantages and benefits like high quality care and substantial cost savings.

The benefits of ambulatory care management are :

* An economy of hospitalization nights cost.
* A decrease in health costs related to the surgery realization.
* Patient satisfaction expected due to hospital discharged within 24 hours. Patient is expected to go home the same day as the surgery with good perception of ambulatory surgery.
* A decrease in the disorientation risk in the elderly patient is also expected.

Surgery is the same with both hospitalization managements.

Patients will be randomized in 2 arms. An arm conventional hospitalization management (control arm) and an arm outpatient care management.

Study period is 30 months. Patients will be following during 6 months. The recruitment time will be 24 months.

Conditions

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Pacemaker Ddd

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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conventional hospitalization management.

The patients who are randomized to have a conventional hospitalization for the pacemaker replacement have conventional management.

In this management patient come to hospital one day before this surgical operation and he is operated next day

Group Type EXPERIMENTAL

Replacement of permanent pacemakers for elective wear.

Intervention Type PROCEDURE

START's intervention is a replacement of permanent pacemakers for elective wear, for the both arms the surgical intervention is the same. The surgical procedure is the same in the both arms.

The differences are in conventional hospitalization, patient comes to hospital one day before operation and he can go out one day after operation. In ambulatory patient come to hospital operation days and he can got out the same day.

ambulatory management

The patients who are randomized to have a ambulatory surgery for the pacemaker replacement have ambulatory management.

In the ambulatory hospitalization patients come to hospital and have a surgical operation the same day

Group Type ACTIVE_COMPARATOR

Replacement of permanent pacemakers for elective wear.

Intervention Type PROCEDURE

START's intervention is a replacement of permanent pacemakers for elective wear, for the both arms the surgical intervention is the same. The surgical procedure is the same in the both arms.

The differences are in conventional hospitalization, patient comes to hospital one day before operation and he can go out one day after operation. In ambulatory patient come to hospital operation days and he can got out the same day.

Interventions

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Replacement of permanent pacemakers for elective wear.

START's intervention is a replacement of permanent pacemakers for elective wear, for the both arms the surgical intervention is the same. The surgical procedure is the same in the both arms.

The differences are in conventional hospitalization, patient comes to hospital one day before operation and he can go out one day after operation. In ambulatory patient come to hospital operation days and he can got out the same day.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Man or woman over 18 years old.
* Replacement of permanent pacemakers for battery elective wear without programmed act in the sensors regardless of pacemaker type, simple, dual or triple chambers and regardless pacemaker label.
* Patient living less than an hour from a hospital center
* Patient is able to answer the phone.
* Patient has an accompaniment the go out night
* Pacemaker-dependent patient or not regardless of indication of placement of the pacemaker
* Patient with or without anticoagulant treatment: the anticoagulant treatment is managed by center under these habits.
* Patient has given this free and informed consent.
* Patient having insurance in France.

Exclusion Criteria

* Ambulatory Hospitalization is impossible.
* Patient refuses to participate
* Patient has hemostasis disorder yielding ambulatory hospitalization impossible.
* Woman is pregnant, nursing mothers or the patient don't receive an effective contraception.
* Patient under guardianship, safeguard of justice
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ministry of Health, France

OTHER_GOV

Sponsor Role collaborator

Nantes University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Vincent Probst

Role: PRINCIPAL_INVESTIGATOR

Nantes University Hospital

Locations

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Lyon University Hospital

Lyon, Bron, France

Site Status

Angers University Hospital

Angers, , France

Site Status

Brest University Hospital

Brest, , France

Site Status

Dijon University Hospital

Dijon, , France

Site Status

Grenoble University Hospital

Grenoble, , France

Site Status

AP-HM

Marseille, , France

Site Status

Montpellier University Hospital

Montpellier, , France

Site Status

Nancy University Hospital

Nancy, , France

Site Status

AP-HP, La Pitié Salpétrière

Paris, , France

Site Status

Rennes University Hospital

Rennes, , France

Site Status

Saint-Etienne University Hospital

Saint-Etienne, , France

Site Status

Strasbourg University Hospital

Strasbourg, , France

Site Status

Toulouse University Hospital

Toulouse, , France

Site Status

Tours University Hopsital

Tours, , France

Site Status

Countries

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France

Central Contacts

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Vincent Probst

Role: CONTACT

0240165093

Imen Fellah

Role: CONTACT

0240165102

Facility Contacts

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Philippe Chevalier

Role: primary

Jean-Marc Dupuis

Role: primary

Jacques Mansourati

Role: primary

Laurent Gabriel

Role: primary

Pascal Defaye

Role: primary

Jean-Claude Deharo

Role: primary

Jean-Luc Pasquié

Role: primary

Nicolas Sadoul

Role: primary

Estelle Grandjbach

Role: primary

Philippe Mabo

Role: primary

Antoine Da Costa

Role: primary

Laurence Jesel

Role: primary

Pierre Mondoly

Role: primary

Dominique Babuty

Role: primary

Other Identifiers

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RC18_0034

Identifier Type: -

Identifier Source: org_study_id

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