New data has been presented demonstrating that use of a wearable ventilator system in COPD patients with chronic respiratory insufficiency is associated with significant improvement in healthcare utilization and overall respiratory health status.
Study findings were released in a session titled "Health Care Utilization and Respiratory Health Status in Patients with Chronic Respiratory Insufficiency Following Addition of a Portable Non-Invasive Ventilator to the Treatment Regimen" at the annual American College of Chest Physicians (CHEST 2015) meeting taking place from October 24-28 in Montreal.
The data were presented by Neil MacIntyre, M.D., F.A.A.R.C., of Duke University Medical Center and included an economic analysis conducted by Kevin Farberow, DHSc, MBA, SCIO Health Analytics® and Richard J. Morishige, M.S., R.R.T., R.A.C., of Clinical Research Consulting, Castro Valley, California.
"Patients with chronic respiratory insufficiency frequently suffer from exacerbations, resulting in increased physician office visits, time in the emergency room and hospital admissions," said Dr. MacIntyre, a leading pulmonologist affiliated with Respiratory Care Services at Duke University Medical Center. "The data analyzed in this study further reinforce current clinical evidence that wearable ventilator technology can improve healthcare utilization measures across a wide spectrum of parameters, help patients with chronic respiratory disease better manage their conditions and have the potential to significantly decrease healthcare expenditures."
The study evaluated 16 stable oxygen-dependent patients with moderate to very severe COPD who were using a one-pound wearable Non-Invasive Open Ventilation (NIOV™) System from Breathe Technologies of Irvine, Calif., as a complement to their standard medical care regimen.
A retrospective chart analysis was conducted for up to one year prior to intervention, capturing diagnosis and clinical characteristics, respiratory function, physician and emergency department visits, hospital and intensive care unit (ICU) days and mechanical ventilation days. Mean health care utilization data and estimated cost reductions, pre- and post-NIOV, are summarized in table 1:
Table 1: Health Care Utilization & Projected Cost Data Pre- and Post-NIOV
| Type of Service | Assumed Cost Per Service (USD) | Pre NIOV Mean | Pre NIOV Mean Cost (USD) | POST NIOV Mean | Post NIOV Mean Cost (USD) | Pre NIOV Mean Total Cost (16 patients) | Post NIOV Mean Total Cost (16 patients) | Mean Total Cost Reduction (%) |
| Office Visit [i] | 305 | 5.4 | 1,647 | 5.9 | 1,800 | 26,352 | 28,792 | 9% |
| Emergency Room Visit [i][ii] | 800 | 1.9 | 1,520 | 0.6 | 480 | 24,320 | 7,680 | -68% |
| Hospital Days [i][ii][iv] | 1,500 | 7.6 | 11,400 | 1.3 | 1,950 | 182,400 | 31,200 | -83% |
| Hospital ICU Days [ii][v] | 3,000 | 2.6 | 7,800 | 0.3 | 900 | 124,800 | 14,400 | -88% |
| Mechanical Ventilations [vi] | 800 | 2.6 | 2,080 | 0.1 | 80 | 33.280 | 1,280 | -96% |
In addition to statistically significant health care utilization across four of five health care utilization measures (emergency room visits, hospital days, hospital ICU days and mechanical ventilations), researchers estimated total cost reductions across the study population of between 68 and 96 percent. Office visits were the only measure that did not achieve significant decreases in frequency or cost.
Additionally, results from two validated patient reported measures of respiratory status were collected. COPD Assessment Test (CAT) and modified Medical Research Council (mMRC) scores improved significantly in the post-NIOV implementation period (p < 0.0001 and p = 0.0001, respectively).
"Treating patients with COPD has significant clinical and economic ramifications for our entire healthcare system," said Dr. Farberow. "The research results indicate there is an exciting opportunity for cost savings related to COPD, while also achieving more independent mobility for those suffering from chronic respiratory insufficiency."
The Breathe NIOV System is a one-pound non-invasive mechanical ventilator that can be used in homecare and institutional settings. More information on the NIOV System from Breathe Technologies is available at http://www.breathetechnologies.com/patient/NIOV/system.