RT Journal Article
SR Electronic
T1 Inpatient transfer for commencement of home NIV: Does a proforma improve practice?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3059
DO 10.1183/13993003.congress-2016.PA3059
VO 48
IS suppl 60
A1 Karen Ward
A1 Helen Ashcroft
A1 Verity Ford
A1 Sara Wordingham-Baker
A1 Robert Angus
A1 Biswajit Chakrabarti
A1 Nick Duffy
A1 Robert Parker
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA3059.abstract
AB Background: Little guidance exists on patient selection for home non-invasive ventilation (NIV) after acute NIV. The role of home NIV in pure COPD is inconclusive (Struik et al. Thorax 2014).Aims: Evaluation of the effect of a referral proforma (RPF) on patient characteristics and outcomes.Methods: The RPF was developed based on current evidence. Data collection pre- and post-RPF included diagnosis, length of stay and survival (Oct '12–Feb '15).Results: Pre-RPF, 55 referrals were received (3.7/month); 8 transfers were not given NIV. Post-RPF, 62 referrals were received (4.8/month), of whom only 25 (40.3%) were referred by RPF. All post-RPF transfers were given NIV; 2 declined.Gender and age varied little (Table One). No significant difference in length of stay, 6- and 12-month survival was seen (pre-RPF v. post-RPF; and pre-RPF v. post-RPF by RPF only).Fewer COPD patients were referred post-RPF (33.9% v. 47.3%, p=0.14). Those referred by RPF were significantly less likely to have COPD than pre-RPF (20.0% v. 47.3%, p=0.02), with increased OHS (obesity hypoventilation; 35.1% v. 21.8%, p=0.04). Referrals without RPF showed similar COPD rates to pre-RPF (47.3% v. 43.2%, p=0.71). ReferralsPre-RPF (n=55)Post-RPF (n=62)Post-RPF by RPF (n=25)Post-RPF no RPF (n=37)Age, years64.9 (12.4)63.4 (12.0)62.8 (12.9)63.7 (11.6)Gender, male21 (38.2)25 (40.3)9 (36.0)16 (43.2)COPD26 (47.3)21 (33.9)5 (20.0)16 (43.2)OHS12 (21.8)24 (38.7)11 (44.0)13 (35.1)Data are number (%) or mean (SD); RPF = referral proformaNIV ReferralsConclusion: While home NIV in COPD is debated, an RPF may improve practice while highlighting the challenges of changing existing behaviours (Stoller, Respiratory Care 2010).