Reuse of Medical Devices and Global Health Equity
Authors: Paul Farmer, Gene Bukhman
Journal: Annals of Internal Medicine (2012)

Editorials16 October 2012Reuse of Medical Devices and Global Health EquityPaul Farmer, MD, PhD and Gene Bukhman, MD, PhDPaul Farmer, MD, PhDFrom Harvard Medical School, Boston, MA 02115.Search for more papers by this author and Gene Bukhman, MD, PhDFrom Harvard Medical School, Boston, MA 02115.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-8-201210160-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The past several decades have been marked by the advent of new technologies designed and marketed to forestall disease progression. Novel diagnostics and therapeutics have been accompanied by scores of new or improved medical devices. These devices include prosthetic joints, advanced wheelchairs, and left ventricular assist devices, and their arrival on the market has often outpaced the knowledge of how and when to deploy them. What are their indications? How well do they work, and for which pathologies? How long should they be used? Are they single-use devices, such as prostheses and pacemakers, or multiuse devices, such as the external ...References1. Epstein AE, DiMarco JP, Ellenbogen KA, Estes , Freedman RA, Gettes LS, et al; American College of Cardiology. American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;51:1-62. [PMID: 18498951] MedlineGoogle Scholar2. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, et al; Multicenter Automatic Defibrillator Implantation Trial II Investigators. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346:877-83. [PMID: 11907286] CrossrefMedlineGoogle Scholar3. Bigger JT. Prophylactic use of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after coronary-artery bypass graft surgery. Coronary Artery Bypass Graft (CABG) Patch Trial Investigators. N Engl J Med. 1997;337:1569-75. [PMID: 9371853] CrossrefMedlineGoogle Scholar4. Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, Hatala R, et al; DINAMIT Investigators. Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med. 2004;351:2481-8. [PMID: 15590950] CrossrefMedlineGoogle Scholar5. Uslan DZ, Gleva MJ, Warren DK, Mela T, Chung MK, Gottipaty V, et al. Cardiovascular implantable electronic device replacement infections and prevention: results from the REPLACE Registry. Pacing Clin Electrophysiol. 2012;35:81-7. [PMID: 22077194] CrossrefMedlineGoogle Scholar6. Boyd C, Hugh-Jones R. Melting down hips and knees: The afterlife of implants. BBC News Magazine. 20 February 2012. Accessed at www.bbc.co.uk/news/magazine-16877393 on 10 September 2012. Google Scholar7. Kohn D. Getting to the heart of the matter in India. Lancet. 2008;372:523-4. [PMID: 18711800] CrossrefMedlineGoogle Scholar8. Farmer PE, Furin JJ, Katz JT. Global health equity. Lancet. 2004;363:1832. [PMID: 15172796] CrossrefMedlineGoogle Scholar9. Pavri BB, Lokhandwala Y, Kulkarni GV, Shah M, Kantharia BK, Mascarenhas DA. Reuse of explanted, resterilized implantable cardioverter-defibrillators. A cohort study. Ann Intern Med. 2012;157:542-8. LinkGoogle Scholar10. Kirkpatrick JN, Papini C, Baman TS, Kota K, Khota K, Eagle KA, et al. Reuse of pacemakers and defibrillators in developing countries: logistical, legal, and ethical barriers and solutions. Heart Rhythm. 2010;7:1623-7. [PMID: 20430113] CrossrefMedlineGoogle Scholar11. Rich ML, Miller AC, Niyigena P, Franke MF, Niyonzima JB, Socci A, et al. Excellent clinical outcomes and high retention in care among adults in a community-based HIV treatment program in rural Rwanda. J Acquir Immune Defic Syndr. 2012;59:35-42. [PMID: 22156912] CrossrefMedlineGoogle Scholar12. Bendavid E, Holmes CB, Bhattacharya J, Miller G. HIV development assistance and adult mortality in Africa. JAMA. 2012;307:2060-7. [PMID: 22665105] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Harvard Medical School, Boston, MA 02115.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-2266.Corresponding Author: Paul Farmer, MD, PhD, Harvard Medical School, Department of Global Health and Social Medicine, 641 Huntington Avenue, Boston, MA 02115.Current Author Addresses: Drs. Farmer and Bukhman: Harvard Medical School, Department of Global Health and Social Medicine, 641 Huntington Avenue, Boston, MA 02115. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoReuse of Explanted, Resterilized Implantable Cardioverter-Defibrillators Behzad B. Pavri , Yash Lokhandwala , Gaurav V. Kulkarni , Mandar Shah , Bharat K. Kantharia , and Daniel A.N. Mascarenhas Metrics Cited By¿Cómo encajará la terapia focal en los tratamientos existentes?How will focal therapy fit in with existing treatments? 16 October 2012Volume 157, Issue 8Page: 591-592KeywordsAIDSAdverse eventsGlobal healthGratitudeHeart diseasesOrgan transplantationTransplantation ePublished: 16 October 2012 Issue Published: 16 October 2012 CopyrightCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...