Quality of life in patients with chronic respiratory failure on home mechanical ventilation

Abstract

Home mechanical ventilation (HMV) is a treatment for chronic respiratory failure that has shown clinical and cost effectiveness in patients with underlying COPD, obesity-related respiratory failure and neuromuscular disease (NMD). By treating chronic respiratory failure with adequate adherence to HMV, improvement in patient-reported outcomes including health-related quality of life (HRQoL) have been evaluated using general and disease-specific quantitative, semi-qualitative and qualitative methods. However, the treatment response in terms of trajectory of change in HRQoL is not uniform across the restrictive and obstructive disease groups. In this review, the effect of HMV on HRQoL across the domains of symptom perception, physical wellbeing, mental wellbeing, anxiety, depression, self-efficacy and sleep quality in stable and post-acute COPD, rapidly progressive NMD (such as amyotrophic lateral sclerosis), inherited NMD (including Duchenne muscular dystrophy) and obesity-related respiratory failure will be discussed.

Acceptability of the Long-Term In-Home Ventilator Engagement virtual intervention for home mechanical ventilation patients during the COVID-19 pandemic: A qualitative evaluation

“… 7 The requirement for travel to specialty HMV clinics can impose significant individual and family burden that may detrimentally impact upon health-related quality of life. 22 Similar to research engaging other Canadian patient populations, most report satisfaction with virtual care; up to one-half identify virtual care as their preferred mode of contact following the pandemic. 23 We found the LIVE Program's acceptability among VAIs and HCPs to be further influenced by ease of use of the LIVE Program application interface and hands-on training opportunities.…”

“…HMV requires overcoming multiple discomforts including those related to the delivery interface and positive airway pressures. 22 Monitoring of HMV prescription adherence and symptom changes are important to potentially avoid complications and disease exacerbations requiring emergency healthcare utilization. HCPs noted how the need for an in-person hospital assessment could be preliminarily determined using the LIVE Program application.…”

Update in Noninvasive Home Mechanical Ventilation: A Narrative Review of Indications, Outcomes, and Monitoring

“…Breathlessness is common in patients with chronic respiratory failure and can be distressing and disabling [ 74 ]. Patient-reported outcome (PRO) tools can help with symptom reporting, and these may be general or disease-specific ( Table 2 ) [ 75 ]. Psychosocial aspects including the effects of treatment burden especially in patients with multimorbidity can impact adherence [ 76 ].…”