⚡ Quick Summary
The European Respiratory Society has released a clinical practice guideline emphasizing the role of telemedicine in the initiation and follow-up of home mechanical ventilation (HMV). This guideline highlights a conditional recommendation for using telemedicine, particularly for patients with neuromuscular diseases and COPD.
🔍 Key Details
- 📊 Task Force: Comprised of 20 members, including patient representatives.
- 🧩 Research Sources: Systematic searches in MEDLINE, EMBASE, Cochrane, and CINAHL.
- ⚙️ Evidence Rating: Certainty of evidence rated using GRADE.
- 🏆 Recommendations: Conditional for telemedicine in HMV initiation and follow-up.
🔑 Key Takeaways
- 📈 Conditional recommendation for telemedicine in initiating HMV for patients with neuromuscular diseases and COPD.
- 🚫 No recommendation for telemedicine in obesity hypoventilation syndrome.
- 💡 Follow-up care can benefit from telemedicine, though specific monitoring parameters remain unclear.
- 🔍 Evidence confidence was rated low, relying on theoretical benefits and patient preferences.
- 🤖 Future research should focus on technological advances, including AI and data processing algorithms.
📚 Background
The increasing prevalence of patients requiring home mechanical ventilation (HMV) has created a pressing need for innovative solutions in patient care. With the evolving landscape of healthcare technology and the constraints on hospital resources, telemedicine emerges as a promising avenue to enhance patient management and follow-up in HMV settings.
🗒️ Study
The European Respiratory Society (ERS) Task Force conducted a comprehensive review to evaluate the role of telemedicine in HMV. The team addressed five PICO questions and three narrative questions, synthesizing evidence through systematic searches and meta-analyses where applicable. The GRADE framework was employed to assess the certainty of the evidence, guiding the formulation of recommendations.
📈 Results
The Task Force concluded with a conditional recommendation for initiating HMV via telemedicine for patients with specific conditions, such as neuromuscular diseases and COPD. However, they could not provide recommendations for patients with obesity hypoventilation syndrome. For follow-up care, while telemedicine was conditionally recommended, the panel could not specify which parameters should be monitored, reflecting a low confidence in the existing evidence.
🌍 Impact and Implications
These guidelines represent a significant step towards integrating telemedicine into the management of HMV. As technology continues to advance, the potential for improved patient outcomes through remote monitoring and follow-up care becomes increasingly viable. The emphasis on patient preferences and the theoretical benefits of telemedicine could pave the way for more personalized and efficient healthcare delivery in the future.
🔮 Conclusion
The ERS clinical practice guideline underscores the importance of telemedicine in enhancing the management of patients on HMV. While the recommendations are conditional and based on limited evidence, they highlight a growing recognition of the role that technology can play in patient care. Continued research into the integration of advanced technologies, such as artificial intelligence, will be crucial for optimizing telemedicine applications in respiratory care.
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European Respiratory Society Clinical Practice Guideline on Telemedicine in Home Mechanical Ventilation.
Abstract
BACKGROUND: With the increasing prevalence of patients on home mechanical ventilation (HMV), changing indications, shortage of hospital resources, and rapidly evolving technology, there is an urgent need for evaluating the added value of telemedicine in initiation and follow-up of HMV. This European Respiratory Society (ERS) clinical practice guideline provides evidence-based recommendations on the use of telemedicine in HMV.
METHODS: The ERS Task Force consisted of 20 members, including a patient representative and her caregiver. The Task Force addressed five PICO questions and three narrative questions. Systematic searches were performed in MEDLINE, EMBASE, Cochrane, CINAHL. Evidence was synthesized by conducting meta-analyses, when possible, or when not, narratively. Certainty of evidence was rated with GRADE (Grading of Recommendations Assessment, Development and Evaluation). The “evidence-to-decision” framework was used to decide on the direction and formulate strengths of recommendations.
RESULTS: The panel makes a conditional recommendation for the initiation of HMV with telemedicine in patients with neuromuscular diseases and in patients with COPD. No recommendation could be made for obesity hypoventilation syndrome. The panel conditionally recommends the use of telemedicine for the follow-up of patients on HMV, although could not make recommendations on parameters to be monitored. Suggestions were mainly based on theoretical benefits and patient preferences, as our confidence in the evidence was low.
CONCLUSIONS: With these guidelines, clinical practice recommendations are provided for the use of telemedicine in HMV. Technological advances and the use of advanced data processing algorithms and artificial intelligence were identified as drivers for future research and telemedicine use.
Author: [‘Duiverman ML’, ‘Ribeiro C’, ‘Tonia T’, ‘Hazenberg A’, ‘van Meerloo S’, ‘van Meerloo H’, ‘Werther S’, ‘Schöbel C’, ‘Özsancak Uğurlu A’, ‘Borel JC’, ‘Jácome C’, ‘Patout M’, ‘Ward K’, ‘Williams C’, ‘Ergan B’, ‘Carlin C’, ‘Murphy P’, ‘Dellacà R’, ‘Vitacca M’, ‘Crimi C’]
Journal: Eur Respir J
Citation: Duiverman ML, et al. European Respiratory Society Clinical Practice Guideline on Telemedicine in Home Mechanical Ventilation. European Respiratory Society Clinical Practice Guideline on Telemedicine in Home Mechanical Ventilation. 2025; (unknown volume):(unknown pages). doi: 10.1183/13993003.00094-2025