Clinical and Economic Effectiveness of Telehealth in Home Mechanical Ventilation

Background The number of patients requiring home mechanical ventilation is rising, while in-person follow-up is increasingly burdensome for patients and health systems. Telehealth may maintain clinical stability and improve care efficiency. This systematic review examined the clinical and economic effectiveness of telehealth in the management of home mechanical ventilation. Methods The study protocol was registered a priori in PROSPERO. A systematic search was conducted in MEDLINE, Embase, and Web of Science. The reporting of the systematic review was aligned with the PRISMA 2020 guidelines. We included quantitative studies comparing telehealth-supported home ventilation with standard care, reporting clinical or economic outcomes. Results From 356 identified studies, eleven met the inclusion criteria: nine RCTs, one cohort study, and one retrospective analysis, mostly conducted in Europe, with a total of 1458 participants. The study populations included patients with e.g. , COPD, ALS and OHS. Interventions involved telehealth-supported home ventilation management. Across studies, telehealth-supported care achieved clinical outcomes comparable to those of standard care. PaCO 2 control and health-related quality of life were similar between groups, with one study reporting greater PaCO 2 reduction with telemonitoring. Evidence on hospitalizations and exacerbations was mixed. Mortality and survival showed non-significant trends towards benefit, one cohort study reported improved first-year survival. Economic outcomes varied: home initiation reduced costs, while long-term follow-up results were heterogeneous. Conclusions Telehealth-supported home ventilation appears to be a comparable alternative to in-hospital management and often provides economic advantages. Future research should focus on standardized outcome measures, longer follow-up, and health-system-specific cost-effectiveness analyses to guide sustainable implementation.