Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/27049
Title: Measuring Adherence to Long-Term Noninvasive Ventilation.
Austin Authors: Chao, Caroline ;Berlowitz, David J ;Howard, Mark E ;Rautela, Linda ;McDonald, Luke A ;Hannan, Liam M 
Affiliation: Department of Respiratory Medicine, Northern Health, Epping, Victoria, Australia
Physiotherapy
The University of Melbourne, Parkville, Victoria, Australia
Respiratory and Sleep Medicine
Institute for Breathing and Sleep
Issue Date: Sep-2021
Date: 2021-07-13
Publication information: Respiratory Care 2021; 66(9): 1469-1476
Abstract: Obtaining benefits from long-term noninvasive ventilation (NIV) relies on achieving adequate adherence to treatment. Reported adherence to NIV is variable and could be influenced by high-volume users and attrition of nonusers and those who die. This observational study aimed to describe patterns of use and adherence rates in new unselected users of NIV. All adults (> 18 y old) commencing long-term NIV were consecutively enrolled and followed for 6 months. Ventilator data were manually downloaded from devices and usage (minutes per day) was collected. Subjects were categorized into adherent users (≥ 4 h/d) and nonadherent users (< 4 h/d). Data were obtained from 86 subjects. Most (65%) had motor neuron disease, and most commenced NIV in an out-patient setting (72%). At one month after NIV implementation, overall average daily use was 302.1 min/d and categorical adherence was 57%. At 6 months or prior to death, overall average daily use increased (388.7 min/d), but categorical adherence was similar (62%). The majority of subjects (84%) remained in the same adherence category from their first month to their sixth month of use or death. Individuals with motor neuron disease demonstrated significantly lower rates of adherence compared to the rest of the cohort at 1 month (48% vs 73%, P = .03). In those who died within the study period (n = 19, all with motor neuron disease), this difference persisted to death (42% at death vs 73% at 6 months, P = .032). Average daily usage may conceal true prevalence of adherence or nonadherence to NIV within a population. Reporting both average daily use data and categorical adherence rates (using a threshold of 4 h/d) may improve transparency of reported outcomes from clinical trials and identifies a therapeutic target for home mechanical ventilation services for quality improvement.
URI: https://ahro.austin.org.au/austinjspui/handle/1/27049
DOI: 10.4187/respcare.08745
Journal: Respiratory Care
PubMed URL: 34257099
Type: Journal Article
Subjects: noninvasive ventilation
patient compliance
respiratory insufficiency
treatment adherence
Appears in Collections:Journal articles

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