Abstract
The increasing number of patients receiving home respiratory therapy (HRT) is imposing a major impact on routine clinical care and healthcare system sustainability. The current challenge is to continue to guarantee access to HRT while maintaining the quality of care. The patient experience is a cornerstone of high-quality healthcare and an emergent area of clinical research. This review approaches the assessment of the patient experience in the context of HRT while highlighting the European contribution to this body of knowledge. This review demonstrates that research in this area is still limited, with no example of a prescription model that incorporates the patient experience as an outcome and no specific patient-reported experience measures (PREMs) available. This work also shows that Europe is leading the research on HRT provision. The development of a specific PREM and the integration of PREMs into the assessment of prescription models should be clinical research priorities in the next several years.
Highlights
Long-term oxygen therapy (LTOT) and/or home mechanical ventilation (HMV) are well-established therapies for patients with chronic respiratory failure, such as those with chronic obstructive pulmonary disease (COPD), neuromuscular diseases, and obstructive sleep apnea (OSA), among others
Of patients starting LTOT in 2015, 88% had severe hypoxemia and 97% had any degree of hypoxemia; 98% were prescribed oxygen for ≥15 hours/day; 76% had both stationary and mobile oxygen equipment; 75% had a mean PaO2 > 8.0 kPa breathing oxygen; and 98% were non-smokers
Various models of ventilator servicing were reported. 64% of providers stated that caregiver competency was a prerequisite for home discharge, but repeated competency assessment and retraining were offered by 45%
Summary
Long-term oxygen therapy (LTOT) and/or home mechanical ventilation (HMV) are well-established therapies for patients with chronic respiratory failure, such as those with chronic obstructive pulmonary disease (COPD), neuromuscular diseases, and obstructive sleep apnea (OSA), among others These therapies represent key services in the home respiratory therapy (HRT) provided to these patients. A number of studies conducted over the last few decades have addressed the beneficial effects of HRT on morbidity, mortality, and adverse outcomes, as well as the variations in HRT provision among countries [5,7,8]. These metrics alone do not provide a complete picture of HRT quality
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