Author(s): Ward K.; Chakrabarti B.; Ashcroft H.J.; Plant P.; Duffy N.; Parker R.; Manuel A.; Wordingham-Baker S.; Ford V.; Angus R.M.
Source: American Journal of Respiratory and Critical Care Medicine; 2018; vol. 197
Publication Date: 2018
Publication Type(s): Conference Abstract
Available at American Journal of Respiratory and Critical Care Medicine – from Edge Hill Aintree LIRC (lib302411) Local Print Collection [location] : Edge Hill Aintree LIRC.
Abstract:Rationale Studies of continuous positive airway pressure (CPAP) therapy suggest mean hours/night when used in the first two weeks may predict longer term use (1, 2). No studies are known of which seek to determine if the same relationship exists in home NIV. Aims To investigate possible association between: * Mean use of NIV in first and final 14 days of a 90-day period. * Defined compliance at the same time points. Methods Retrospective review of patients receiving telemonitored NIV (ResMed Lumis 150) within LSV, from time of device launch. All patients who underwent inpatient initiation of therapy, and received NIV >=90 days before time of data collection (completing the routine telemonitored period) were included. Patients who received ambulatory initiation were deliberately excluded. Age, gender and diagnosis were collected, and telemonitoring data was reviewed: * Mean NIV use (hours/night when used), first and final 14 days of 90. * Percentage of nights used, same time points. Compliance was defined as >=4 hours use per night, >=75% of nights. Results From Nov. 2015 to July 2017, 93 patients began telemonitored NIV; n=90 completed follow-up, while three died. Mean age of survivors was 60.7 years (SD 23.3), and 44% were male. The largest diagnosis group was obesity hypoventilation syndrome (OHS; n=31, 34.4%), followed by chronic obstructive pulmonary disease (COPD; n=20, 22.2%). Mean hours of NIV per night when used was 5.38 (SD 2.63) days 1-14, and 5.25 (SD 3.44) days 77-90. Defined compliance was seen in 62% of patients in days 1- 14, and 57% of patients in days 77-90. A strong positive correlation was seen between mean hours of NIV use in the first and final 14 days (Spearman’s rho 0.78, p = 0.01; Figure 1). Compliance in the first 14 days also positively correlated with compliance in the final 14 days (Spearman’s rho 0.61, p=0.01). Conclusions Both defined compliance, and mean hours use of NIV, correlated strongly in the first and final 14 days; this may focus follow-up, to support those less likely to adhere. For home NIV, consideration of percentage of nights used in a measure of compliance may be more clinically meaningful where nightly use of therapy is desired. (Figure Presented).