P199 Impact of the increasing evidence base of the benefits of home mechanical ventilation in patients with chronic obstructive pulmonary disease on a home mechanical ventilation service: one regional service’s experience

BackgroundThere is an increasing evidence base to support the use of home mechanical ventilation (HMV) in chronic obstructive pulmonary disease (COPD) Kohnlein1et al (2014) demonstrated an improvement in 12 month mortality in a stable COPD population with chronic hypercapnia and the Murphy et al2 (2017) demonstrated prolongation to first admission or death, following an acute episode of hypercapnic respiratory failure. However, little is known about the impact on such evidence in this patient group on clinical services.AimTo identify the number of patients with COPD referred for consideration of HMV and subsequently set up on HMV within our regional specialist HMV service per year over a 5 year period (2014–2019).ResultsDuring this five year, our service saw a year on year increase in referrals for consideration for HMV in patients with COPD (figure 1). Over the 5 year period our referrals for patients with COPD increased by 118% with an 131% in set ups per year, with the biggest increase in referrals and set ups being seen following the publication of the Murphy et al paper from 2017–2018 onwards (see figure 1).In consequence, we have recruited both a respiratory consultant and respiratory specialist nurse to our HMV team to ensure that this patient group is reflected in the clinical make up of our specialist team.ConclusionsWith the increasing body of evidence supporting the use of HMV in patients with COPD, we have demonstrated a more than doubling in both the number of referrals and patients being set up on HMV with COPD within our regional service over a 5 year period.ReferencesKohnlein, et al. Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial. Lancet Respir Med 2014;2(9):698–705.Murphy, et al. Effect of home noninvasive ventilation with oxygen therapy vs oxygen therapy alone on hospital readmission or death after an acute COPD exacerbation: A Randomized Clinical Trial. JAMA 2017;317(21):2177–2186.Abstract P199 Figure 1Referral and commencement of COPD patients on HMV