Home Non-Invasive Ventilation in Patients with Chronic Obstructive Pulmonary Disease: A Survey of Current Practice in Italy.

IF 2.6 3区医学 Q2 RESPIRATORY SYSTEM

Respiration Pub Date : 2026-01-01 Epub Date: 2025-12-05 DOI:10.1159/000549778

Claudia Crimi, Annalisa Carlucci, Lara Pisani, Scott Gibson, Carlo Bellatorre, Anna Panza, Sarah Alami

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Abstract

Introduction: Optimal initiation and management of long-term home non-invasive ventilation (LTH-NIV) therapy requires a personalised approach that may not be possible within some healthcare systems. This survey of Italian physicians determined current practices regarding LTH-NIV initiation and follow-up in patients with chronic hypercapnic chronic obstructive pulmonary disease (COPD), areas for process improvements, and use of telemonitoring.

Methods: A 35-question survey was developed then sent via email for completion using computer-assisted web interviewing methodology. Respondents were Italian hospital-based physicians identified using a healthcare professional database who had 3 years' experience in pulmonology, treated/followed up at least 50 patients on NIV, and consented to participate.

Results: Sixty of 71 physicians approached completed the online survey. Of these, 41/60 (68%) said that LTH-NIV prescription followed hospitalisation for acute COPD exacerbation. The most important clinical aspects to monitor early after discharge and during long-term follow-up were reported as mask fit and patient quality of life. Physicians reported a high workload for management of patients on LTH-NIV but felt that many therapy management tasks could be performed by other providers, especially outpatient pulmonologists and homecare providers. Only 32% of respondents were currently using telemonitoring; reasons for non-use were lack of human resources (63%) or regulatory framework (37%), and cost/reimbursement issues (22%).

Conclusion: These data highlight substantial differences between LTH-NIV clinical practice for chronic hypercapnic COPD in Italy and current guidelines, suggesting that guideline-mandated processes may not be achievable or sustainable in real-world settings. Involvement of homecare providers and use of telemonitoring could help improve the management of LTH-NIV therapy.

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慢性阻塞性肺疾病患者的家庭无创通气：意大利目前实践的调查

长期家庭无创通气（LTH-NIV）治疗的最佳启动和管理需要个性化的方法，这在某些医疗保健系统中可能是不可能的。这项对意大利医生的调查确定了慢性高碳酸血症性慢性阻塞性肺疾病（COPD）患者LTH-NIV启动和随访的现行做法，流程改进的领域和远程监测的使用。方法：一份35个问题的调查，然后通过电子邮件发送，使用计算机辅助网络访谈方法完成。调查对象是意大利医院的医生，通过医疗保健专业数据库确定，他们具有3年的肺病学经验，治疗/随访了至少50例使用NIV的患者，并同意参与研究。结果：60/71的受访医生完成了在线调查。其中，41/60（68%）的患者在急性COPD加重住院后使用LTH-NIV处方。出院后早期和长期随访期间监测最重要的临床方面是口罩的适合度和患者的生活质量。医生报告说，LTH-NIV患者的管理工作量很大，但他们认为许多治疗管理任务可以由其他提供者执行，特别是门诊肺科医生和家庭护理提供者。只有32%的受访者目前正在使用远程监控；不使用的原因是缺乏人力资源（63%）或监管框架（37%），以及成本/报销问题（22%）。结论：这些数据突出了意大利慢性高碳酸血症性COPD的LTH-NIV临床实践与现行指南之间的实质性差异，表明指南规定的过程在现实环境中可能无法实现或可持续。家庭护理提供者的参与和远程监控的使用可以帮助改善LTH-NIV治疗的管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respiration 医学-呼吸系统

CiteScore

7.30

自引率

5.40%

发文量

审稿时长

4-8 weeks

期刊介绍： ''Respiration'' brings together the results of both clinical and experimental investigations on all aspects of the respiratory system in health and disease. Clinical improvements in the diagnosis and treatment of chest and lung diseases are covered, as are the latest findings in physiology, biochemistry, pathology, immunology and pharmacology. The journal includes classic features such as editorials that accompany original articles in clinical and basic science research, reviews and letters to the editor. Further sections are: Technical Notes, The Eye Catcher, What’s Your Diagnosis?, The Opinion Corner, New Drugs in Respiratory Medicine, New Insights from Clinical Practice and Guidelines. ''Respiration'' is the official journal of the Swiss Society for Pneumology (SGP) and also home to the European Association for Bronchology and Interventional Pulmonology (EABIP), which occupies a dedicated section on Interventional Pulmonology in the journal. This modern mix of different features and a stringent peer-review process by a dedicated editorial board make ''Respiration'' a complete guide to progress in thoracic medicine.