Cost‐effectiveness analysis of using the heat and moisture exchangers compared with alternative stoma covers in laryngectomy rehabilitation:<scp>US</scp>perspective

Beck, Ann Jean C.C.; Retèl, Valesca P.; Bunting, Glenn; Sethi, Rosh K.V.; Deschler, Daniel G.; Brekel, Michiel W. M. van den; Harten, Wim H. van

doi:10.1002/hed.26442

Cited by 7 publications

(8 citation statements)

References 51 publications

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“…36-42 Nevertheless, patients with COPD experience pulmonary symptoms similar to those of patients after laryngectomy, 43-46 and COPD is a common comorbidity for them. 47,48…”

Section: Discussionmentioning

confidence: 99%

“…[36][37][38][39][40][41][42] Nevertheless, patients with COPD experience pulmonary symptoms similar to those of patients after laryngectomy, [43][44][45][46] and COPD is a common comorbidity for them. 47,48 Although no normative data are currently available for patients with total laryngectomy, the extent of improvement obtained in each of the 4 domains is most likely clinically significant. Indeed, a published work on patients with COPD concluded that improvements of 10.6 for cough symptom, 10.1 for cough impact, 9.5 for sputum symptom, and 7.8 for sputum impact were clinically relevant.…”

Section: Discussionmentioning

confidence: 99%

“…This is the first time that the CASA‐Q questionnaire (validated for chronic obstructive pulmonary disease [COPD]) has been used to assess patients after laryngectomy 36‐42 . Nevertheless, patients with COPD experience pulmonary symptoms similar to those of patients after laryngectomy, 43‐46 and COPD is a common comorbidity for them 47,48 …”

Section: Discussionmentioning

confidence: 99%

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Optimizing Pulmonary Outcomes After Total Laryngectomy: Crossover Study on New Heat and Moisture Exchangers

Longobardi

Galli

Cesare

et al. 2022

Otolaryngol.--head neck surg.

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Objective To evaluate the effects of new devices—heat and moisture exchangers (HMEs) and adhesives—on pulmonary symptoms, subject adherence, quality of life, dermatologic symptoms, and patient satisfaction after laryngectomy. Study Design Prospective crossover study. Setting Between December 2020 and April 2021, 40 patients were enrolled who had undergone laryngectomy, routinely used HMEs and adhesive, and were followed in our Department of Otolaryngology–Head and Neck Surgery. Methods Patients were allocated into group A (new products) or group B (usual care) for 6 weeks. Then the 2 groups reversed, and each patient acted as his or her own control. Patients kept a diary and cough tally sheet. At baseline and after each 6-week period, 2 questionnaires were administered: EQ-5D (European Quality of Life–5 Dimensions) and CASA-Q (Cough and Sputum Assessment Questionnaire). Results Six weeks of using new products resulted in the following effects for both groups: (1) a significant reduction in daily forced expectoration and dry coughs, (2) a significant improvement in all domains of the CASA-Q, (3) an increase in adherence to HME use, (4) a significant reduction in shortness of breath and skin irritation, and (5) significantly better scores in the anxiety/depression domain of the EQ-5D. Conclusion Achieving this reduction in patients who were already highly adherent to HME use is clinically relevant and underscores the importance of using better-performing HMEs that can compensate for the humidification deficit. Improving pulmonary symptomatology could reduce patient restrictions in daily life and avoidance of social activity, with a consequent positive effect on quality of life.

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“…36-42 Nevertheless, patients with COPD experience pulmonary symptoms similar to those of patients after laryngectomy, 43-46 and COPD is a common comorbidity for them. 47,48…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Optimizing Pulmonary Outcomes After Total Laryngectomy: Crossover Study on New Heat and Moisture Exchangers

Longobardi

Galli

Cesare

et al. 2022

Otolaryngol.--head neck surg.

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“…For those unable to meet the additional costs, or for those who may find using multiple devices too complex or cognitively demanding, the data from Phase 1 of this study demonstrates that simply exchanging the patients baseline HMEs with comparable HMEs from the new generation range can still achieve some incremental positive pulmonary and other symptom benefits. Prior studies have proven HMEs to be cost‐effective 10,27 . A full assessment of the incremental cost‐effectiveness of the change in routine using Provox Life is planned to investigate if the added 0.8 HME utilization can be justified by improvements in clinical outcomes and any impacts to quality of life.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8] Recognizing the negative consequences of total laryngectomy on pulmonary function, the use of heat and moisture exchanger (HME) devices are considered best practice care for pulmonary rehabilitation postsurgery. 1,[9][10][11] Attached over the tracheostoma, HMEs typically consist of a plastic housing containing polyurethane foam treated with a hygroscopic salt (e.g., calcium chloride, lithium chloride) to enhance absorption of water vapor and warmth upon inhalation. 1,12 Inhaled air passing through the warm, moist foam of the HME is conditioned and some particulate matter is filtered.…”

Section: Introductionmentioning

confidence: 99%

Post‐laryngectomy pulmonary and related symptom changes following adoption of an optimal day‐and‐night heat and moisture exchanger (HME) regimen

et al. 2023

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Background: This study examined post-laryngectomy pulmonary and related symptom changes following establishment of an optimal day/night regimen (all day/night wear of devices with improved humidification) using a new generation range of heat and moisture exchanger (HME) devices. Methods:In Phase 1 (6 weeks), 42 post-laryngectomy HME users transitioned from their usual HME regime to equivalent new device/s (i.e., "like-for-like"). In Phase 2 (6 weeks) participants used the full range of HMEs to achieve an optimal day/night regimen. Pulmonary symptoms, device use, sleep, skin integrity, quality of life and satisfaction were examined at baseline, and weeks 2 and 6 of each Phase.Results: From baseline to end of Phase 2, cough symptoms and impact significantly improved, as did sputum symptoms, sputum impact, duration and types of HMEs used, reasons for HME replacement, involuntary coughs, and sleep. Conclusion:The new HME range supported improved HME use, with pulmonary and related symptom benefits.

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Adoption and Utilization of Heat and Moisture Exchangers (HMEs) in the Tracheostomy Patient

Kearney,

Norris,

Bertelsen

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveManagement of tracheostomized patients typically involves a conventional external humidification system (CEHS). CEHS are noisy, negatively impact patient mobility, and increases costs. Additionally, they prevent phonation and the ability to cough. Alternatively, heat and moisture exchange (HME) devices have been used in laryngectomized patients. We present an institutional quality improvement project exploring the use and efficacy of an HME device following tracheostomy.MethodsHealth care professionals and stakeholders from multiple disciplines were identified: otolaryngology, nursing, administration, case management, and speech‐language pathology. The focus was on an otolaryngology acute care nursing unit. Protocols for product acquisition, nursing education, care flowcharts, and discharge planning were established. Efficacy was assessed by tracking patient pulmonary status, nursing notes, and questionnaires.ResultsSeventy‐one tracheostomized patients were enrolled. Two patients (2.8%) were unable to tolerate the HME. There were no complications from mucous plugging or respiratory distress. Eighty‐nine percent of nursing staff surveyed preferred the use of an HME device over CEHS, particularly for ease of patient mobility. Additional favorable findings were patient satisfaction, cost savings, reduced noise, communication, and ease of discharge education and planning.DiscussionReplacing CEHS with HMEs provides distinct advantages, with a positive impact on patients, family members, and health care personnel. Resistance to changing from the traditional standard of care was alleviated with education, focused training, and positive outcomes.Implications for PracticeThese data indicate that an HME device is safe and offers advantages to both patients and nurses over traditional CEHS.

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Cost‐effectiveness analysis of using the heat and moisture exchangers compared with alternative stoma covers in laryngectomy rehabilitation:USperspective

Cited by 7 publications

References 51 publications

Optimizing Pulmonary Outcomes After Total Laryngectomy: Crossover Study on New Heat and Moisture Exchangers

Optimizing Pulmonary Outcomes After Total Laryngectomy: Crossover Study on New Heat and Moisture Exchangers

Post‐laryngectomy pulmonary and related symptom changes following adoption of an optimal day‐and‐night heat and moisture exchanger (HME) regimen

Adoption and Utilization of Heat and Moisture Exchangers (HMEs) in the Tracheostomy Patient

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