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

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 1st July 2022 to 30th 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.