Home Mechanical Ventilation Practices in Spain and Portugal

• Published in: Open respiratory archives 2021-07, Vol.3 (3), p.100116-100116, Article 100116
• Main Authors: Antón, Antonio, Díaz Lobato, Salvador, Guimarães, Maria José, Alonso-Álvarez, Mari Luz, Correia, Sara, Gonçalves, Miguel R.
• Format: Article
• Language: English
• Subjects: Chronic respiratory failure; Cuestionario; Diferencias geográficas; Encuesta; Geographical differences; Hipercapnia; Home mechanical ventilation; Hypercapnia; Insuficiencia respiratoria crónica; Original; Questionnaire; Survey; Ventilación mecánica domiciliaria
• ISSN: 2659-6636; 2659-6636
• DOI: 10.1016/j.opresp.2021.100116

Home mechanical ventilation (HMV) practice has changed with publication of new evidence and introduction of new technologies, and varies between countries. This study investigated current HMV use and practices in Spain and Portugal. 94 healthcare professionals identified as regularly performing HMV-related activities were sent an e-mail link to an online questionnaire. The questionnaire included 40 items relating to responder demographics, non-invasive ventilation (NIV) care structure, ventilated patient profile, work habits, and potential future practice improvements. 66 questionnaires (70%) were returned (Spain, 36; Portugal, 30). The majority of respondents were physicians (Spain, 95%; Portugal, 63%). Overall, 83% of hospitals had a dedicated NIV unit (Spain, 100%; Portugal, 63%). The most common indication for HMV was neuromuscular disorders in Spain and obstructive diseases in Portugal. Homecare providers (HCPs) and pulmonologists were usually responsible for managing HMV; HCPs were involved more often in Portugal. Choice of ventilator was most often based on usage hours/day; the most important device features were ‘ease of use’ (Spain) and ‘adjustment range’ (Portugal). HMV monitoring practices varied between countries. Telemonitoring was used more often in Portugal (20%; vs. Spain, 3%). Follow-up frequency and practices also differed markedly between Spain and Portugal. Respondents highlighted identification of new patient groups and patient phenotyping to optimize treatment and personalize therapy as future HMV strategies. Important differences in the management of HMV were observed between two similar European countries. Better understanding of clinical practices can facilitate targeted education and training to ensure optimal management of patients using HMV. El manejo de la ventilación mecánica domiciliaria (VMD) ha cambiado tras la publicación de información nueva y la introducción de nuevas tecnologías, y varía entre países. Este estudio investigó el uso y el manejo actuales de la VMD en España y Portugal. Noventa y cuatro profesionales de la salud que realizaban actividades relacionadas con la VMD con regularidad recibieron un enlace mediante correo electrónico a un cuestionario en línea. El cuestionario incluyó 40 ítems relacionados con la demografía de los encuestados, la estructura de cuidados de la ventilación no invasiva (VNI), el perfil del paciente ventilado, los hábitos de trabajo y las posibles mejoras en el futuro manejo de la VMD.