Non-invasive home ventilation in COPD may reduce the risk of hospitalization

Non-invasive home ventilation, known as NIVH, may reduce the risk of hospitalization, emergency room visits, and death in people with chronic obstructive pulmonary disease (COPD) who struggle to get enough. oxygen, according to new research.

NIVH is a breathing assistance technique administered at home, using a face or nasal mask, which aims to keep breathing and blood oxygen levels stable.

“Because COPD has no cure, treatment is palliative; goals include reducing mortality and hospitalizations and improving [quality of life]The researchers wrote.

The results of this research, reported in “Non-invasive home ventilation reduces COPD mortality with CRF“, Show that the use of non-invasive treatment in some patients has led to” statistically significant and clinically significant reductions in hospitalizations and [emergency department] visits compared to patients not treated with NIVH, ”the researchers wrote.

The study, published in The American Journal of Managed Care, was funded by Viemed Healthcare, which manufactures medical equipment for the NIVH.

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“We are very pleased to see again published evidence that supports the clinical efficacy of NIVH on the highest risk chronic respiratory patients, and we are delighted to continue to share these results with the medical community,” Casey Hoyt , CEO of Viemed, said in a press release.

Hoyt said the results “confirm the findings of a separate study” published late last year, which “used different statistical methods and studied a different patient population than that used in the current study.” Nonetheless, the new findings add to the company’s data supporting the use of its NIVH products, according to Hoyt.

COPD is a chronic inflammatory disease of the lungs, in which the patient’s airways become blocked, causing a cough with mucus, wheezing, and shortness of breath. As the disease progresses to a more severe stage, it can cause chronic respiratory failure, or COPD-CRF, a condition in which the lungs are not able to efficiently transmit oxygen and remove oxygen. carbon dioxide from the bloodstream.

The potential benefits of NIVH in people with COPD-CRF are still being explored.

Today, a group led by scientists from Viemed performed an analysis of Medicare data in the United States collected between 2012 and 2017. Using this data, the team identified 410 people with COPD-CRF. prescribed NIVH within two months of being diagnosed with CRF. For comparison, the team evaluated the outcomes of 36,247 COPD-CRF patients who never received NIVH (controls).

The team conducted a battery of statistical tests to see if the use of NIVH was associated with significantly different outcomes in terms of hospitalizations or mortality.

One year after diagnosis, 56.3% of patients were taking NIVH and 64.6% of controls were hospitalized. In addition, 70% of patients who received NIVH went to the emergency room, compared to 87.7% of controls. One-year mortality rates after CRF diagnosis were 29.4% in patients who received NIVH and 42.4% in controls.

Statistical models indicated that NIVH significantly reduced the risk of hospitalization by about 21%, according to company researchers. The risk of going to the emergency room was also significantly reduced by around 42.9%, as was the risk of death by around 38.3%.

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Notably, NIVH’s benefit in terms of emergency room visits and deaths declined over time, while its hospitalization benefit appeared to remain stable over similar longer time periods.

“After 69 weeks NIVH no longer showed a survival benefit, and after 81 weeks it no longer showed a reduced risk of erectile dysfunction. [emergency department] visits, ”the researchers wrote.

An important caveat about these results is that the statistical models used by researchers rely on certain mathematical assumptions to ensure their accuracy. The analyzes indicated that for the effect of NIVH on mortality and emergency department visits, some of these assumptions may not be true. The team suggested that this could be because the effect seemed to vary over time from diagnosis, pointing to the need for more research, especially to assess the effect of NIVH on mortality.

“NIVH was associated with lower risks of hospitalizations and [emergency department] visits to patients with COPD-CRF. More research is needed to examine the effect of NIVH on all-cause mortality, ”the team concluded.

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