Resource impact summary report

The early value guidance recommends that KardiaMobile 6L can be used in psychiatric services as an option to measure cardiac QT interval for adults having or about to have antipsychotic medication while more evidence is generated. Data capture will be undertaken and reviewed at the end of the evidence generation period (3 years).

The number of people aged 18 years and over who receive antipsychotic medication is estimated to be around 1,500 per 100,000 population in England (Medicines Used in Mental Health – England 2015/16 to 2022/23, NHS BSA 2023). People taking antipsychotic medications may need to be tested for cardiac abnormalities before starting medication and at regular intervals during treatment. Detection of cardiac abnormalities can inform choice of therapy, dosing, whether to discontinue therapy, and potentially avoid severe cardiac events. Current practice is to use 12‑lead electrocardiogram (ECG) devices in primary or secondary care centres.

Life expectancy for adults diagnosed with psychosis or schizophrenia is between 15 and 20 years less than the general population, which is in part due to physical comorbidities including cardiovascular disorders. These can be exacerbated using certain antipsychotic medications, potentially giving rise to QT interval prolongation (NICE scope).

The KardiaMobile 6L is a portable handheld 6‑lead ECG device.

Due to a lack of robust data on current and future practice and the variation across organisations and services, the size of the resource impact will need to be determined at a local level.

Depending on current local practice, areas that may require additional resources and result in additional costs include:

  • Costs for healthcare professionals who need access to KardiaMobile devices in the community and clinic settings. Clinical experts advise that the number of devices needed will vary by setting and location. Each device will need a licence for which there is an annual fee. The number of devices and licence fees can be adjusted in the resource impact template.
  • Time for interpretation of the result from KardiaMobile 6L, which involves manual calculations and may involve psychologist or cardiologist time.
  • Additional capacity demand for community nurses to provide QT assessment in the community with KardiaMobile 6L, for people receiving antipsychotic medication, where 12-lead ECG assessment was previously carried out in a clinical setting. Any additional capacity impact may be partly offset where the assessment is moving from a 12-lead ECG and a cardiac technician’s time is reduced per procedure.

Implementing the guideline may:

  • reduce the number of outpatient and GP appointments for 12-lead ECGs, where KardiaMobile 6L is used as triage before a 12-lead ECG
  • enable people to access antipsychotic medication in a timelier manner with a clearer understanding of the QT risk for the individual.

Psychiatric services are commissioned by NHS England. Providers are community providers, mental health trusts and GPs.

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