Social determinants of pacemaker reuse among patients and family members in Pakistan

ABSTRACT

Objectives

This survey aimed to quantify the opinions of CIED reuse among patients and family members in Pakistan and to identify the social determinants which may predict these views.

Methods

A questionnaire formulating attitudes toward PPM reuse was administered to patients and family members at cardiology institutes in Pakistan from 1 July 2022 to 30 September 2022. The eligibility criteria (age > 18 years; inline for PPM placement) were taken into account and incomplete responses were excluded from the final analysis.

Results

A total of 9,246 participants recorded their responses, of which 7,152 (78.16%) accepted pre-used PPMs. The lower social class had more PPM reuse acceptance rate than the middle and upper class (92.72% vs. 60.52% vs. 35.38%), respectively. Age ≥ 65 (OR(95%CI): 0.68 (0.41–0.99); P-value = 0.023), male gender (OR(95%CI): 0.55 (0.35–0.72), P-value = 0.016), unemployment (OR(95%CI): 0.47 (0.25–0.64); P-value = 0.007), poor health status (OR(95%CI): 0.72 (0.53–0.92); P-value = 0.041), and lower social class (OR(95%CI): 0.36 (0.28–0.53); P-value = 0.003) were social determinants of PPM reuse acceptance.

Conclusion

Patients and their family members endorse the concept of PPM reuse in Pakistan who cannot afford new devices.

KEYWORDS:

• Low-income country
• South Asia
• global South
• implantable devices

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.