Clinical and economic benefits of HMV telemonitoring in Brazil

Abstract

<b>Introduction:</b> Despite the advantages of using telemonitoring (TM) to manage home mechanical ventilation (HMV) patients, especially during the COVID-19, this practice is not widely used in Brazil. <b>Objectives:</b> Verify if a TM program for HMV patients is associated with better outcomes and lower costs in a case/control study. <b>Methods:</b> HMV patients were followed for 8 months (4 months pre-TM/4 months post-TM). Multi professional care was delivered according to home care provider protocols in both periods. Post-TM was performed using an online platform (AirView), allowing the clinician to review ventilation parameters on a daily basis and examine the trends of domiciliary therapy. After clinical evaluation, interventions were applied proactively to optimise HMV treatment. The costs of antibiotic therapy offering (AB), extra clinical visits, exacerbation with rehospitalisation and weaning from HMV were evaluated. Statistical analysis was done with chi-square test. <b>Results:</b> 20 HMV patients (6 Astral; 2 Stellar; 12 AirCurve ST-A), 69±23 years; 45% male; 47% neurologic, 20% COPD were included. HMV duration before enrollment was 8.5±7.5 months. Compared with pre-TM, post-TM presented lower percentage of patients using AB (67% vs 22%; <i>p</i>=0.002), higher ventilation weaning (0% vs 27%; <i>p</i>=0.01), lower extra clinical visits (38 vs 3 total visits and 40% vs 10% patients visited; <i>p</i>&lt;0.05), lower rehospitalization due to exacerbation (70% vs 10%; <i>p</i>=0.01). Post-TM group presented an overall cost saving of US $54,843.61 (US$685.54 per patient/month of saving). <b>Conclusion:</b> Our results highlight that the use of TM-HMV patients is a feasible tool and associated with better clinical outcomes and a cost saving.