Background Chronic obstructive pulmonary disease (COPD) contributes substantially to morbidity, mortality, and healthcare costs. For patients with chronic respiratory failure, long-term home non-invasive ventilation (LTH-NIV) is an effective therapy, yet existing guidelines offer little direction on the most effective initiation and organization of care. We review current LTH-NIV implementation and management strategies and factors that facilitate or hinder successful treatment. Methods A systematic review of studies investigating the organization and implementation of LTH-NIV for COPD patients was performed. Studies reporting primary clinical, economic, or organizational data on LTH-NIV with home-based care were included, with a particular focus on interventions aiming to improve outcomes or care organization. The findings were synthesized narratively. PROSPERO: CRD42025648464. Findings From 870 records, 46 studies were included. The majority were from Europe, with fewer studies from Asia and North America. Differences in how LTH-NIV is delivered to COPD patients were identified, with variation in initiation settings, stakeholder involvement, and follow-up strategies. Hospital-based initiation remained common, although outpatient and home-based models, often supported by remote titration or telemonitoring, were increasingly used. Follow-up was typically scheduled every 3–6 months across outpatient, inpatient, and home-based modalities. Successful care relied on patient education, technical support, and structured follow-up, supported by remote consultations. These new strategies promise improved patient comfort, adherence, communication, and collection of patient-centred outcomes. Telemonitoring emerged as a promising adjunct, enhancing individualized care, facilitating closer follow-up and early identification of technical or clinical issues. Interpretation The delivery of LTH-NIV remains heterogeneous, even within countries. This variability in care organization and reporting mandates establishing harmonized, patient-centred pathways that integrate telemonitoring and coordinate collaboration among stakeholders, ensuring that patients and their caregivers remain central to the care process.
Organization and delivery of home-based care for chronic obstructive pulmonary disease patients receiving long-term home non-invasive ventilation: a systematic review
Crimi C.
Primo
Writing – Original Draft Preparation
;
2026-01-01
Abstract
Background Chronic obstructive pulmonary disease (COPD) contributes substantially to morbidity, mortality, and healthcare costs. For patients with chronic respiratory failure, long-term home non-invasive ventilation (LTH-NIV) is an effective therapy, yet existing guidelines offer little direction on the most effective initiation and organization of care. We review current LTH-NIV implementation and management strategies and factors that facilitate or hinder successful treatment. Methods A systematic review of studies investigating the organization and implementation of LTH-NIV for COPD patients was performed. Studies reporting primary clinical, economic, or organizational data on LTH-NIV with home-based care were included, with a particular focus on interventions aiming to improve outcomes or care organization. The findings were synthesized narratively. PROSPERO: CRD42025648464. Findings From 870 records, 46 studies were included. The majority were from Europe, with fewer studies from Asia and North America. Differences in how LTH-NIV is delivered to COPD patients were identified, with variation in initiation settings, stakeholder involvement, and follow-up strategies. Hospital-based initiation remained common, although outpatient and home-based models, often supported by remote titration or telemonitoring, were increasingly used. Follow-up was typically scheduled every 3–6 months across outpatient, inpatient, and home-based modalities. Successful care relied on patient education, technical support, and structured follow-up, supported by remote consultations. These new strategies promise improved patient comfort, adherence, communication, and collection of patient-centred outcomes. Telemonitoring emerged as a promising adjunct, enhancing individualized care, facilitating closer follow-up and early identification of technical or clinical issues. Interpretation The delivery of LTH-NIV remains heterogeneous, even within countries. This variability in care organization and reporting mandates establishing harmonized, patient-centred pathways that integrate telemonitoring and coordinate collaboration among stakeholders, ensuring that patients and their caregivers remain central to the care process.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
