Home-Based Care Evolution in Chronic Respiratory Failure between 2001 and 2015 (Antadir Federation Observatory)
Autor: | Didier Foret, L. Mounier, Arnaud Chambellan, Boris Melloni, Jean-François Muir, J. P. Laaban |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Young Adult 03 medical and health sciences 0302 clinical medicine Patient age Oxygen therapy Obesity Hypoventilation Syndrome medicine Humans 030212 general & internal medicine Continuous positive airway pressure Aged Aged 80 and over Obesity hypoventilation syndrome COPD Noninvasive Ventilation Continuous Positive Airway Pressure business.industry Middle Aged medicine.disease Home Care Services Home based Oxygen 030228 respiratory system Chronic Disease Emergency medicine Breathing Female Respiratory Insufficiency business Chronic respiratory failure |
Zdroj: | Respiration. 96:446-454 |
ISSN: | 1423-0356 0025-7931 |
Popis: | Background: The aetiologies of chronic respiratory failure (CRF) are moving in many western countries. Obesity-Hypoventilation syndrome (OHS) has become one of the most common indications of non-invasive ventilation (NIV) with Chronic Obstructive Pulmonary Diseases (COPD). Long-Term Oxygen Therapy (LTOT) technology is the treatment plan for CRF patients in the new era. Objectives: This study aimed to assess home-based care evolution in CRF patients on LTOT (LTOT) and/or NIV from the ANTADIR observatory. Methods: A computerized database from 14 regional facilities was analysed (30% of French home-treated patients). Patient age, sex, aetiology, home respiratory devices were recorded between 2001 and 2015. Results: By the end of 2015, 12,147 CRF patients received LTOT (40%), NIV (24%), LTOT + NIV (23%), continuous positive airway pressure (CPAP; 11%) or LTOT + CPAP (3%). Between 2001 and 2015, we observed a decrease of LTOT (63–40%) in the benefit of NVI ± LTOT (25–47%). Regarding the aetiology, we note a slight decrease in obstructive disease and a significant increase in restrictive disease, mainly due to OHS. The 10-year survival was better on NIV ± LTOT than on LTOT, for overall patients and for both obstructive and restrictive patients. The 10-year survival was better on NIV ± LTOT than on LTOT (35 vs. 10%, p < 0.05). In COPD patients on LTOT, a switch from conventional to new home devices was observed. Stationary LTOT systems were less prescribed, while portable/transportable system, liquid oxygen and self-filling oxygen were increasingly prescribed. Conclusion: Our study confirmed changes in CRF aetiologies and home devices. OHS is now an important indication of NIV. Using new LTOT technologies changed home prescriptions in COPD patients. |
Databáze: | OpenAIRE |
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