Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2022 Nov 9;22(1):410.
doi: 10.1186/s12890-022-02195-5.

Starting HMV at home: a reasonable option for many patients?

Affiliations
Clinical Trial

Starting HMV at home: a reasonable option for many patients?

Ries J M van den Biggelaar et al. BMC Pulm Med. .

Abstract

Background and objective: In the current study, we undertook a more detailed exploration of the reasons why patients undergoing HMV were screened out of a recently published study in order to better understand how applicable home initiation of HMV is under real life conditions.

Methods: All referred patients who had an indication for starting HMV were screened to participate in the Homerun study. In this trial 512 patients were screened out of the study. Those patients not enrolled in the trial were divided into the following 3 groups: (1) those not fulfilling the inclusion criteria; 2) those meeting the exclusion criteria and 3) those excluded on the basis of medical or organisation reasons. Each group was then further divided into those who would likely have been suitable for initiation of HMV at home in real world practice and those who were unsuitable.

Results: Based on inclusion criteria (group 1) 116 patients could not start HMV in real life, while this was 245 patients in the study. Based on the exclusion criteria (group 2) 11 patients could not start in real life while this was 79 in the study. One hundred and eighty-eight could not be enrolled in the study due to medical and organisational reasons ( group 3), while in real life this was only 95.

Conclusion: This study indicates that more than 55% of patients who did not participate in the Homerun study could have started HMV at home in real life.

Keywords: Health care organization; Home mechanical ventilation; Patient selection; Telemonitoring.

PubMed Disclaimer

Conflict of interest statement

Dr. van den Biggelaar reports personal fees from Philips, and Westfalen Medical B.V., both outside the submitted work. Dr. Hazenberg, Dr. Cobben, Dr. Gaytant and Dr. Gommers have nothing to disclose. Prof. Dr. Wijkstra reports grants from ZONMW, grants from VIVISOL, during the conduct of the study; grants and personal fees from Philips, grants and personal fees from RESMED, grants from Goedegebuure, grants from vital air, personal fees from Bresotec, and personal fees from Synapse, outside the submitted work.

Figures

Fig. 1
Fig. 1
Flowchart of patient exclusion divided into main groups and subcategories
Fig. 2
Fig. 2
Distribution of patients fulfilling the inclusion criteria of the Homerun study versus real life
Fig. 3
Fig. 3
Distribution of patients meeting the exclusion criteria for the Homerun study versus real life
Fig. 4
Fig. 4
Comorbidity and organisational reasons for not participating in the Homerun study vs. real life
Fig. 5
Fig. 5
Summary of reasons for not starting HMV at home by category for the Homerun study vs. real life

References

    1. Cantero C, Adler D, Pasquina P, et al. Long-Term Noninvasive Ventilation in the Geneva Lake Area: Indications, Prevalence, and Modalities. Chest. 2020;158:279–91. doi: 10.1016/j.chest.2020.02.064. - DOI - PubMed
    1. van den Biggelaar RJM, Hazenberg A, Cobben NAM, Gaytant MA, Vermeulen KM, Wijkstra PJ. A Randomized Trial of Initiation of Chronic Noninvasive Mechanical Ventilation at Home vs In-Hospital in Patients With Neuromuscular Disease and Thoracic Cage Disorder: The Dutch Homerun Trial. Chest. 2020. - PubMed
    1. Hazenberg A, Kerstjens HA, Prins SC, Vermeulen KM, Wijkstra PJ. Initiation of home mechanical ventilation at home: a randomised controlled trial of efficacy, feasibility and costs. Respir Med. 2014;108:1387–95. doi: 10.1016/j.rmed.2014.07.008. - DOI - PubMed
    1. Duiverman ML, Vonk JM, Bladder G, et al. Home initiation of chronic non-invasive ventilation in COPD patients with chronic hypercapnic respiratory failure: a randomised controlled trial. Thorax. 2019. - PMC - PubMed
    1. Doménech-Clar R, Nauffal-Manssur D, Compte-Torrero L, Rosales-Almazán MD, Martínez-Pérez E, Soriano-Melchor E. Adaptation and follow-up to noninvasive home mechanical ventilation: ambulatory versus hospital. Respir Med. 2008;102:1521–7. doi: 10.1016/j.rmed.2008.07.018. - DOI - PubMed

Publication types