Patterns of home mechanical ventilation use in Europe: results from the Eurovent survey

Abstract

The study was designed to assess the patterns of use of home mechanical ventilation (HMV) for patients with chronic respiratory failure across Europe.A detailed questionnaire of centre details, HMV user characteristics and equipment choices was sent to carefully identified HMV centres in 16 European countries.A total of 483 centres treating 27,118 HMV users were identified. Of these, 329 centres completed surveys between July 2001 and June 2002, representing up to 21,526 HMV users and a response rate of between 62% and 79%. The estimated prevalence of HMV in Europe was 6.6 per 100,000 people. The variation in prevalence between countries was only partially related to the median year of starting HMV services. In addition, there were marked differences between countries in the relative proportions of lung and neuromuscular patients using HMV, and the use of tracheostomies in lung and neuromuscular HMV users. Lung users were linked to a HMV duration of ,1 yr, thoracic cage users with 6-10 yrs of ventilation and neuromuscular users with a duration of o6 yrs.In conclusion, wide variations exist in the patterns of home mechanical ventilation provision throughout Europe. Further work is needed to monitor its use and ensure equality of provision and access.

Prevalence and variability of use of home mechanical ventilators, positive airway pressure and oxygen devices in the Lombardy region, Italy

“…The Eurovent Survey found that HMV variability concerned both the number of prescriptions and the profile of patients for whom this treatment was prescribed, neither of which was related to the characteristics of the healthcare system or the economic situation in the country involved [1]. The national Swedish HMV register also highlighted variability in prescription within the country itself, despite a similar level of healthcare coverage [14,15].…”

“…The last reported prevalence (though probably underestimated) of European patients requiring HMV is 6.6/100,000 population [1]. Although HMV has been shown to reduce patients' symptoms, improve health-related quality of life (HRQL) and, in many cases, reduce mortality and hospitalizations [2,3] there are problems connected with providing HMV, such as inadequate patient/caregiver training and lack of compliance, dis-homogeneous reimbursement policies and insufficient resources [4].…”

“…Although HMV has been shown to reduce patients' symptoms, improve health-related quality of life (HRQL) and, in many cases, reduce mortality and hospitalizations [2,3] there are problems connected with providing HMV, such as inadequate patient/caregiver training and lack of compliance, dis-homogeneous reimbursement policies and insufficient resources [4]. Differences in the availability of HMV, and in reimbursement regarding evidencebased medical policies/indications, may also lead to wide variations in the prevalence and the patterns of HMV provision throughout Europe [1,5]. The number of respiratory units and specialists available in a particular area can also account for the variability in prescription, as has been observed in other respiratory therapies such as home oxygen therapy [6].…”

Außerklinische Intensivpflege: Aktuelle Herausforderungen im Hygienemanagement

“…1 Im Stadtgebiet München wurden im November 2014 bei einer Einwohnerzahl von 1,49 Millionen 2 192 intensivpflegebedürftige Klienten betreut. Dies entspricht einer deutlich über dem europaweiten Durchschnitt liegenden Rate von 12,8 pro 100.000 Einwohner.…”

Tele-monitoring of ventilator-dependent patients: a European Respiratory Society Statement

“…The reported, although probably underestimated, prevalence of patients with chronic respiratory failure (CRF) requiring home mechanical ventilation (HMV) in Europe is 6.6 per 100 000 people [1]. There are challenges when providing HMV, including patients and caregiver training, adequacy of respiratory care, reimbursement policy, and need of patient/family cooperation [2].…”