Care Practices and Health-related Quality of Life for Individuals Receiving Assisted Ventilation. A Cross-National Study

AuthorsHannan, LM.
Sahi, H.
Road, JD.
McDonald, CF.
Berlowitz, DJ.
Howard, ME.
TypeJournal Article (Original Research)
JournalAnnals of the American Thoracic Society
PubMed ID27295155
Year of Publication2016
URLhttp://www.atsjournals.org/doi/10.1513/AnnalsATS.201509-590OC#.V9nwadJ95hE
DOIhttp://dx.doi.org/ 10.1513/AnnalsATS.201509-590OC
AbstractRATIONALE:
Comparisons of home mechanical ventilation services have demonstrated considerable regional variation in patient populations managed with this therapy. The respiratory care practices used to support individuals receiving assisted ventilation also appear to vary, but they are not well described. It is uncertain whether differences in the approach to care could influence health outcomes for individuals receiving assisted ventilation.
OBJECTIVES:
We sought to identify and describe the respiratory care practices of home ventilation providers in two different regions and determine whether care practice differences influence health-related quality of life.
METHODS:
We conducted a cross-national survey of individuals receiving assisted ventilation managed by two statewide home mechanical ventilation providers, one in Victoria, Australia, and the other in British Columbia, Canada. The survey was used to evaluate care practices, functional and physical measures, socioeconomic attributes, and health-related quality of life.
MEASUREMENTS AND MAIN RESULTS:
Overall, 495 individuals receiving assisted ventilation (57.2%) responded to the survey. Responders had clinical attributes similar to those of nonresponders. The Canadian population had a greater proportion of individuals with neuromuscular disorders and lesser percentages with obesity hypoventilation syndrome and chronic obstructive pulmonary disease. We also found marked differences in the reported care practices in Canada that were not fully explained by population differences. Subjects in the Canadian sample were more likely than their Australian counterparts to use invasive mechanical ventilation (24.2% vs. 2.5%; P < 0.001), to use routine airway clearance techniques (28.9% vs. 14.8%; P < 0.001), and to have had home implementation of noninvasive ventilation (39.9% vs. 3.6%; P < 0.001). Subjects in the Australian population were more likely than those in Canada to have undergone polysomnography to evaluate their ventilatory support (93.9% vs. 37.4%; P < 0.001). There was no difference in summary measures of health-related quality of life between the two sites. In a multivariable regression model, age, ability to perform activities of daily living, physical function, employment, and household income were all independently associated with health-related quality of life, but neither geographic location (Canada vs. Australia) nor underlying diagnosis were significant factors in the model.
CONCLUSIONS:
In two cohorts of individuals receiving assisted ventilation, one in Australia and the other in Canada, we found marked differences in both the care practices employed and the populations served. Despite these regional differences, measures of health-related quality of life were not different. Further research is required to examine costly or burdensome interventions that are currently used routinely in the management of individuals receiving assisted ventilation.

http://www.ibas.org.au/what-we-do/publications/3872860


< More publications



SHiQ - COSAQSHIQ - COSAQ

Each year in Australia 260 people sustain a SCI, with over half losing full function in their arms and legs (quadriplegia). In addition to the primary disability, there is a very high rate of Obstructive...

Notch monitoring in sleepNOTCH MONITORING IN SLEEP

Sleep apnea is a condition where breathing is abnormal during sleep. There are two main forms of sleep apnea: obstructive and central. For obstructive sleep apnea, breathing is reduced because the airway...

IBAS Director Anna Burke unveiling of her portrait at Canberra's Parliament HouseIBAS DIRECTOR ANNA BURKE UNVEILING OF HER PORTRAIT AT CANBERRA'S PARLIAMENT HOUSE

Anna Burke had barely got into the swing of her speech at the unveiling of her portrait at Canberra's Parliament House when the ringing of bells caused half her audience to hurry away

Thunderstorm asthma expected to return in 2017THUNDERSTORM ASTHMA EXPECTED TO RETURN IN 2017

The Morning Show - Thunderstorm asthma expected to return in 2017. The Daily Edition - Thunderstorm Asthma is an unexpected killer. Better Health Channel - Thunderstorm asthma explained. Professor Christine McDonald

National study offers hope for breathlessnessNATIONAL STUDY OFFERS HOPE FOR BREATHLESSNESS

A national medication study is aiming to help thousands of Australians who struggle every day with shortness of breath

Helping Victorians breathe and sleep easy - A New Centre of Excellence in Respiratory and Sleep MedicineHELPING VICTORIANS BREATHE AND SLEEP EASY - A NEW CENTRE OF EXCELLENCE IN RESPIRATORY AND SLEEP MEDICINE

With your support we will build a life-changing Centre of Excellence in Respiratory and Sleep Medicine, improving quality of life and health outcomes for Victorians who struggle to breathe and sleep

Institute for Breathing and Sleep

Bowen Centre, Austin Hospital
145 Studley Road
Heidelberg, Victoria, 3084

(03) 9496 5390

Email Us

Donate