Effectiveness of Adherence to Home Non-Invasive Ventilation (NIV) upon Hospitalisation Rate and Mortality of Chronic Obstructive Pulmonary Disease Patients with Chronic Hypercapnic Respiratory Failure: A Structured Literature Review.

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) with Chronic Hypercapnic Respiratory Failure (CHRF) has a significant impact on hospitalisation rate and mortality. Non-invasive ventilation (NIV) is a clinically established home-based intervention; however, its impact on hospitalisation rate and mortality remains undetermined.

Review Aim: This review aims to investigate existing literature to establish the impact of adherence to home NIV on reducing hospitalisation rate and mortality among patients with COPD and CHRF.

Method: Between May 2024 and June 2024, this review conducted a systematic literature search of the primary medical databases (MEDLINE, Cochrane Library, CINAHL and Embase). A quality assessment was conducted using the Newcastle-Ottawa Quality Assessment tool and the National Heart, Lung, and Blood Institute (NIH) quality assessment tool.

Findings: Six observational studies, involving 10,206 participants, analysed the impact of adherence to home NIV on hospitalisation rate and mortality. Five studies were considered to be high quality and one was moderate quality. Adherence to home NIV for at least four hours per day was associated with a significant reduction in hospitalisation rate and mortality.

Conclusion: Adherence to home NIV significantly reduces hospitalisation rate and mortality among COPD patients with CHRF. These findings recommend the adoption of home NIV as a standard care practice for this population and emphasise the importance of patient compliance to maximise the therapeutic benefits of NIV. This review recommends that future research conducts additional randomised control trials (RCTs) to reinforce its initial findings.