Compliance with home non-invasive mechanical ventilation in patients with chronic respiratory failure: Telemonitoring versus usual care surveillance - a randomized pilot study

Introduction. Home Non-invasive Mechanical Ventilation (HNIMV) may need a more accurate surveillance particularly in the first weeks. Telemonitoring may add value in that follow-up. Objectives. Analyze the effects of telemonitoring on HNIMV compliance in patients with Chronic Respiratory Failure (CRF). Methods. Thirty nine patients with hipercapnic CRF were included and followed during 3 months. All patients were first adapted at hospital setting to bi-level positive pressure ventilation (A30, Phillips Respironics®). Patients were randomized to Telemedicine Clinical Care group (TCC) and Usual Clinical Care group (UCC). TCC patients had their ventilator linked with an oximetry module and a GSM module (Phillips Respironics®) to transmit data wirelessly. Ventilator data (Encore Anywhere and Encore Pro 2, Phillips Respironics®) of both groups were analyzed and compared. Results. Data are presented as median (25-75). Four patients dropped out and 1 rejected to participate and so were all excluded. Twenty patients were included in TCC group and 19 in UCC group. Twenty two (56,4%) with Restrictive Disorders and 17 (43,6%) with Obstructive Disorders. Patients had a median diurnal PaCO2 of 51,3 (46,3-57,2) mmHg and PaO2 of 65,7 (58,7-72) mmHg. At 3 months, when compared to UCC, TCC patients had a significant increase in the average hours of daily use (6.9 (6.4-7.6) vs 4.6 (1.3-6.3), p<0,01), and in the % of Usage Days (UD) >6h (83.3 (69-91.8) vs 36.6 (4.5-74.1) %, p<0,01). Conclusion. The results of this study suggest that telemonitoring tools can improve HNIMV compliance in patients with CRF of different etiologies.