One-year experience of domiciliary non-invasive ventilation (NIV) monitoring via wireless modem in a district general hospital (DGH)

Abstract

The use of domiciliary NIV for type 2 respiratory failure is well recognised. NHS England recommends that complex home ventilation services should be delivered by specialist centre. However many patients find travel to tertiary centre difficult and distressing. Aims: The objectives of this study are to review the impact of the modem domiciliary ventilation on patients monitoring over 1 year period. NIV is initiated at home and a modem enable monitoring and assessment of domiciliary delivered ventilation in real time. Methods: Retrospective data on all patients receiving domiciliary NIV via wireless modem between January and December 2015 were collected. We examined: rate of hospital admissions, intervention changes and place of death. Results: 33 patients received domiciliary NIV and were monitored via wireless modem. 12 has died, 3 dropped out and 18 continued treatment. 6 patients received domiciliary NIV as a result of MND and 24 due to decompensated COPD. Place of death was reviewed on 11 patients that died. None of them died in acute hospital. One died in Community Hospital, 4 in hospice and 6 at home. Intervention rate was examined on 18 patients that continued treatment. Mean (range) number of months on NIV was 5 (11-2). Mean (range) modem settings change was 1.2 times (13-0). Out of all 18 patients who continued therapy 4 of them had hospital admissions. Conclusions: We believe that monitored domiciliary NIV via a modem reduces treatment and travel burden by monitoring remotely and locally. It enables multidisciplinary team to intervene promptly when escalation or palliative care is required and reduce hospital admissions.