Organization and delivery of home-based care for chronic obstructive pulmonary disease patients receiving long-term home non-invasive ventilation: a systematic review.

In 30 seconds

This systematic review examined how long-term home non-invasive ventilation (LTHNIV) is initiated and managed for people with COPD. It included 46 studies identified from 870 records, with most studies conducted in Europe. Care varied in initiation setting, stakeholder involvement, and follow-up. Hospital initiation remained common, while outpatient and home-based approaches, often using remote titration or telemonitoring, were increasingly reported. Follow-up was typically scheduled every 3–6 months. The review found that education, technical support, and structured follow-up were central features of successful care, while telemonitoring appeared promising for closer, more individualized support.

Key findings

• The review included 46 studies from 870 records; most were conducted in Europe.
• Hospital-based initiation remained common, but outpatient and home-based models with remote titration or telemonitoring were increasingly used.
• Follow-up was typically scheduled every 3–6 months across outpatient, inpatient, and home-based care.
• Patient education, technical support, and structured follow-up were identified as important to successful care; telemonitoring may help identify technical or clinical issues earlier.

Why it matters

LTHNIV care is organized differently across settings and even within countries, making it difficult to ensure consistent support for patients and caregivers. The review highlights practical components—education, technical assistance, coordinated follow-up, and remote monitoring—that may help services deliver more individualized care and identify problems. Its findings also underscore the need for clearer, patient-centred care pathways.

What to keep in mind

The review synthesized heterogeneous studies narratively, and the abstract does not report pooled estimates of clinical or economic outcomes.