281 Home delivery of the communicator for remote monitoring of cardiac implantable devices: a multicentre experience during the COVID-19 lockdown

Aims During the COVID-19 pandemic in-person visits for patients with cardiac implantable electronic devices should be replaced by remote monitoring (RM), in order to prevent viral transmission. A direct home-delivery service of the RM communicator has been implemented at 49 Italian arrhythmia centres. Methods and results According to individual patient preference or the organizational decision of the centre, patients were assigned to the home-delivery group or the standard in-clinic delivery group. In the former case, patients received telephone training on the activation process and use of the communicator. In June 2020, the centres were asked to reply to an ad hoc questionnaire to describe and evaluate their experience in the previous 3 months. RM was activated in 1324 patients: 821 (62%) received the communicator at home and the communicator was activated remotely. Activation required one additional call in 49% of cases, and the median time needed to complete the activation process was 15 min (25th–75th percentile: 10–20). 753 (92%) patients were able to complete the correct activation of the system. At the time when the questionnaire was completed, 743 (90%) communicators were regularly transmitting data. The service was generally deemed useful (96% of respondents) in facilitating the activation of RM during the COVID-19 pandemic and possibly beyond. Conclusions Home delivery of the communicator proved to be a successful approach to system activation, and received positive feedback from clinicians. The increased use of a RM protocol will reduce risks for both providers and patients, while maintaining high-quality care.

Increasing participation in the 2019 UK general election amongst patients on a high intensity rehabilitation ward

AimsTo increase participation in the 2019 UK general election amongst inpatients on a high intensity rehabilitation ward, by supporting patients to both register to vote (RTV) and vote.BackgroundIn 2000, the franchise was extended to those under section 2 or 3 as well as informal inpatients. Unfortunately, voting rates remain low: studies of the 2010 general election show voting rates amongst psychiatric inpatients to be 14%, compared to 65% for the general population. Engaging patients in the democratic process is not only just, it has been shown to be an effective avenue for rehabilitation through increasing social capital. The 2019 UK general election represents a singular opportunity for biopsychosocial rehabilitation.MethodIn the three weeks up until 26/11/19 – the deadline to RTV – visual displays and verbal information were used to notify patients of: The electionTheir eligibilityThe need to RTV before casting a ballotThe registration deadlineVoting methods (in person, by post, by proxy)We gathered patients’ intention to RTV and offered impartial, personalised support to register online or by paper, and to apply for a postal or proxy ballot if wished. Patients with no fixed abode were supported to use the ward as their declared place of residence.ResultOf the 17 patients on the ward there were:Four informal patients11 patients under section 3One patient each under a section 37 and a section 37/41, both ineligible to voteOf the 15 eligible patients, one (6.7%) had already registered, six patients (40%) wanted to register and eight (53.3%) stated they did not want to register. Those wanting to register were supported according to individual patient preference. Of the registered seven, five (33.3%) reported voting, one (6.7%) reported not having voted and one (6.7%) declined to say. Two (13.3%) voted in person and five (33.3%) voted by postal ballot.ConclusionOur intervention corresponded with an increase in number of patients registering – from one patient (6.7%) to seven (46.7%), with 5-6 (33.3-40%) casting their ballot. While the causal relationship should not be overstated, the uptake of assistance supports the intervention's efficacy.Good rehabilitation increases a person's social capital, empowering them to actively participate in societal life. Registering to vote is a tacit assertion of this principle. Our study shows that brief interventions that are easily incorporated into everyday care are a simple, effective and ultimately necessary tool in holistic mental health rehabilitation.