Patient Compliance to Non-Invasive Ventilation in Sub-Intensive Care Unit: An Observational Study

Background: Thesuccessof noninvasiveventilationdependsonmanyfactorsandeffectivedeliveryrequiresteamwork. Information on the therapeutic program must be sustained by healthcare staff and family. Objectives: Investigate the clinical and care factors that affect the level of patient compliance to non invasive ventilation. Methods: A prospective, observational and multicentre study was conducted between November 1, 2015 and February 15, 2016 in three sub-intensive wards. A data collection tool was created with the working definition of “Patient intolerant to non invasive ventilation” and a structured interview was conducted to investigate patient experience of NIV. Statistical analysis was conducted with the STATA MP13 software. Results: Coordination of patient-ventilator interaction prevents intolerance (OR = 0.68, 95% IC 0.46 - 0.98; P = 0.04). Overweight andobesepatientsshowedahigherprobabilityof intolerancetononinvasiveventilationwithrespecttounderweightandnormal weight patients (OR = 0.53, 95% IC 0.34 - 0.82; P = 0.005). Patients with a higher probability of intolerance experienced a NRS level of 4/5 (OR = 1.76, 95% IC 1.30 - 2.41; P ≤ 0.001) while receiving continuous treatment (OR = 1.26, 95% IC 1.04 - 1.53; P = 0.019). Patients in open-space settings experienced less intolerance (4.7 SD ± 1.2) with respect to patients in single rooms (2.5 SD ± 0.9). Anxious patients developed more intolerance than calm and informed patients (OR = 7.39, 95% IC 3.19 - 17.13; P ≤ 0.001) Conclusions: Compliance to non invasive ventilation depends on multiple factors, including relational aspects that affect treatment success. Attention to patient comfort, pain control, and collaboration with the caregiver appear to have the most influence on patient compliance.