Homecare Respiratory Support for Patients with Chronic Respiratory Failure: the Necessity of a Long-Term Homecare Ventilation Program

Abai Baigenzhin 1, Alexey Pak 2 * , Lina Zaripova 3, Zhanar Zarkumova 4 5, Elmira Chuvakova 6
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1 Chairman of the Board, National Scientific Medical Center, Astana, Kazakhstan
2 Head of Internal Medicine Institute, National Scientific Medical Center, Astana, Kazakhstan
3 Department of Scientific and Innovation Management, National Scientific Medical Center, Astana, Kazakhstan
4 JSC National Scientific Medical Center, Astana, Kazakhstan
5 Astana Medical University, Astana, Kazakhstan
6 Deputy Chairman of the Board in the field of science, National Scientific Medical Center, Astana, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 21, Issue 5, pp. 56-60. https://doi.org/10.23950/jcmk/15493
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Author Contributions: P.A., conceived of the presented idea. L.Z., and Zh.Z., worked on developing the theory. E.Ch., verified the analytical methods. A.B., supervised the findings of this work. All authors discussed the results and contributed to the final manuscript. The authors have read and agreed to the published version of the manuscript.

ABSTRACT

Severe respiratory failure, resulting from a wide range of acute and chronic diseases such as chronic obstructive pulmonary diseases, obstructive sleep apnoea, obesity hypoventilation syndrome (Pickwickian syndrome), COVID-19, bilateral pneumonitis, kyphoscoliosis, acute respiratory distress syndrome, amyotrophic lateral sclerosis, Guillain-Barré syndrome, and others, poses a significant challenge for healthcare systems worldwide. Treating severe respiratory failure often requires long-term or lifelong respiratory support, which places a heavy burden on both patients and healthcare systems. Despite the availability of free comprehensive care for patients with chronic kidney failure and heart failure, those requiring long-term respiratory support are often deprived of adequate medical and social assistance. This gap in care leads to frequent hospitalizations, disability, and premature death of patients with severe respiratory failure, further straining healthcare resources and increasing social tension. The solution of the problem is an organisation of ambulatory centre for homecare respiratory support for patients with severe chronic respiratory failure. Homecare respiratory support demonstrated worldwide cost-effectiveness by significantly enhancing patients clinical and social outcomes, restoring their work capacity, and reducing the need for hospitalizations. This article emphasizes the necessity of a comprehensive homecare respiratory support system and highlights how inadequate assistance can result in frequent hospitalizations, increased disability, and premature death, thereby imposing an additional strain on the healthcare system.

CITATION

Baigenzhin A, Pak A, Zaripova L, Zarkumova Z, Chuvakova E. Homecare Respiratory Support for Patients with Chronic Respiratory Failure: the Necessity of a Long-Term Homecare Ventilation Program. J CLIN MED KAZ. 2024;21(5):56-60. https://doi.org/10.23950/jcmk/15493

REFERENCES

  • Surani S, Taweesedt P. Obstructive Sleep Apnea: New Perspective. Medicina (Kaunas). 2022; 59(1): 75. https://doi.org/10.3390/medicina59010075.
  • World H88alth Statistics 2016 [OP]: Monitoring Health for the Sustainable Development Goals (SDGs). 2016: World Health Organization.
  • Benjafield AV et al., Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. The Lancet Respiratory Medicine. 2019; 7(8): 687–698. https://doi.org/10.1016/S2213-2600(19)30198-5.
  • Toussaint M et al. Building a home ventilation programme: population, equipment, delivery and cost. Thorax. 2022; 77(11): 1140–1148. https://doi.org/10.1136/thoraxjnl-2021-218410.
  • Kim HI et al. Home Mechanical Ventilation Use in South Korea Based on National Health Insurance Service Data. Respir Care. 2019; 64(5): 528–535. https://doi.org/10.4187/respcare.06310.
  • Hall J et al. Cost-effectiveness of domiciliary non-invasive ventilation in patients with chronic obstructive pulmonary disease. Thorax. 2022; 77(10): 976–986. https://doi.org/10.1136/thoraxjnl-2021-217463.
  • Chandra D et al. Outcomes of noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease in the United States, 1998-2008. Am J Respir Crit Care Med. 2012; 185(2): 152–159. https://doi.org/10.1164/rccm.201106-1094OC.
  • Kempker JA et al. The Epidemiology of Respiratory Failure in the United States 2002-2017: A Serial Cross-Sectional Study. Crit Care Explor. 2020; 2(6): e0128. https://doi.org/10.1097/CCE.0000000000000128.
  • Plant PK et al. Cost effectiveness of ward based non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease: economic analysis of randomised controlled trial. Bmj. 2003; 326(7396): 956. https://doi.org/10.1136/bmj.326.7396.956.
  • Toussaint M et al. Building a home ventilation programme: population, equipment, delivery and cost. Thorax. 2022; 77(11): 1140–1148. https://doi.org/10.1136/thoraxjnl-2021-218410.
  • Dretzke J et al. The cost-effectiveness of domiciliary non-invasive ventilation in patients with end-stage chronic obstructive pulmonary disease: a systematic review and economic evaluation. Health Technol Assess. 2015; 19(81): 1–246. https://doi.org/10.3310/hta19810.
  • Tuggey JM, Plant PK, Elliott MW. Domiciliary non-invasive ventilation for recurrent acidotic exacerbations of COPD: an economic analysis. Thorax. 2003; 58(10): 867–871. https://doi.org/10.1136/thorax.58.10.867.
  • Janssens JP et al., Monitoring Long Term Noninvasive Ventilation: Benefits, Caveats and Perspectives. Front Med (Lausanne). 2022; 9: 874523. https://doi.org/10.3389/fmed.2022.874523.
  • Morsy NE et al., Obstructive sleep apnea: personal, societal, public health, and legal implications. Rev Environ Health. 2019; 34(2): 153–169. https://doi.org/10.1515/reveh-2018-0068.
  • van den Biggelaar RJM et al. 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; 158(6): 2493–2501. https://doi.org/10.1016/j.chest.2020.07.007.
  • Hazenberg A et al. Initiation of home mechanical ventilation at home: a randomised controlled trial of efficacy, feasibility and costs. Respir Med. 2014; 108(9): 1387–1395. https://doi.org/10.1016/j.rmed.2014.07.008.
  • Ando H et al. Experience of telehealth in people with motor neurone disease using noninvasive ventilation. Disabil Rehabil Assist Technol. 2021; 16(5): 490–496. https://doi.org/10.1080/17483107.2019.1659864.
  • Borel J-C et al. Parameters recorded by software of non-invasive ventilators predict COPD exacerbation: a proof-of-concept study. Thorax. 2015; 70(3): 284–285. https://doi.org/10.1136/thoraxjnl-2014-206569.
  • Vidigal L et al. Clinical and economic benefits of HMV telemonitoring in Brazil. European Respiratory Journal. 2021; 58(suppl 65): PA2108. https://doi.org/10.1183/13993003.congress-2021.PA2108.