HOME TELEMONITORING OF NON INVASIVE VENTILATION DECREASES HEALTHCARE UTILIZATION IN A PROSPECTIVE CONTROLLED TRIAL OF ALS PATIENTS

Anabela Cardoso Pinto (1) , José Pedro Almeida (2) , Susana Candeias Pinto (3) , João Pereira (4) , António Oliveira Gouveia (5) , Mamede De Carvalho (6)

1 Department of Physical Medicine and Rehabilitation, University of Lisbon Medical School, Santa Mari
2 Neuromuscular Unit, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon
3 Neuromuscular Unit, Institute of Molecular Medicine, University of Lisbon Medical School, Lisbon, P
4 Linde Homecare Co, Lisbon, Portugal
5 Department of Biostatistics
6 Neuromuscular Unit, Institute of Molecular Medicine, University of Lisbon Medical School,D Lisbon,

Background. Non-Invasive Ventilation (NIV) is an efficient method for treating respiratory failure in ALS patients. However, it requires a process of adaptation not always achieved because of poor compliance. The role of technology for telemonitoring of NIV compliance is not yet established. Objectives: to compare compliance to NIV and health care utilization of tight follow-up in office visits or with modem communication plus office visits. Design: prospective, single blinded (researchers SP and MC) controlled trial. Population and methods: 40 consecutive, ventilated ALS patients that were by simple random assigned, to a control group (G1, n=20) whose compliance and ventilator parameters settings were assessed during office visits, or to an intervention group (G2, n=20) where patients received a modem device connected to the ventilator (Goodnight®425ST). Results: There were no statistical differences at admission in clinical and demographic characteristics between groups. The amount of intolerant patients was lower in G2 (ns). No differences over time in parameters settings and compliance. The incidence density of changes in parameters settings throughout the survival period with NIV was lower in G2 (p<0.0001) and it was greater in G2 during the initial period of days needed to achieve full compliance. The incidence density of the number of office visits, emergency room visits and in-hospital admissions was significantly lower in G2 (p<0.0001). Overall survival showed a trend favoring G2 (p=0.13 by the log-rank test). Conclusions. This study shows that telemonitoring reduces health care utilization despite a closer follow-up at initial stages of NIV adaptation with probable favorable implications on survival and functional status.

Mots clés: MOTOR NEURON DISEASE; RESPIRATORY MEDICINE; TELEMETRY

Anabela Cardoso Pinto, José Pedro Almeida, Susana Candeias Pinto, João Pereira, António Oliveira Gouveia, et al.. HOME TELEMONITORING OF NON INVASIVE VENTILATION DECREASES HEALTHCARE UTILIZATION IN A PROSPECTIVE CONTROLLED TRIAL OF ALS PATIENTS. Journal of Neurology, Neurosurgery and Psychiatry, 2010, 81 (11), pp.1238. ⟨10.1136/jnnp.2010.206680⟩. ⟨hal-00574381⟩