Breaking down the barriers for patients needing Home Mechanical Ventilation with Alison Armstrong

Friday, July 28, 2023

Alison Armstrong is the Nurse Consultant within the North-East Assisted Ventilation Service, based at Newcastle upon Tyne Hospitals NHS Foundation Trust. Alison has worked within the field of long-term ventilation for over 20 years. She was involved in the development of the medical home ventilation competency based curriculum for the Faculty of Intensive Care Medicine, which is now formerly adopted by the GMC.  She also led on further modification of this document which is now a long-term ventilation educational framework used for training and competency assessment of non-medical health care professionals working in the field of long-term ventilation. Alison is also the host of the Specialists in Long-term Ventilation at Home (SiLVaH) group, current Chair of the BTS Education and Training Committee and the Chair of Home Mechanical Ventilation in Partnership (HMViP).

 

Back in 2019, the Home Mechanical Ventilation in Partnership Group – a collaboration between patients, carers and a multidisciplinary team of healthcare professionals - set itself the task of setting a better agenda for patients with underlying conditions who may require assessment for home mechanical ventilation, working towards improvement in HMV services and better access to information and support for patients, their families and carers.  

Three and a half years later, the group successfully launched World HMV Day in May, adding this awareness day to the healthcare calendar with the intention of sharing the benefits which HMV can provide to certain patient groups and to highlight how it can significantly improve the quality of these patients’ lives, as well as calling on NHS Trusts to consider the value of providing HMV access to patients.

In the inaugural weekend of World HMV Day, we added 99 brand new visitors to the site from the UK and around the globe, from the US to Australia, Sweden and Malta, and many other countries in-between, and welcomed back many existing users. Our patient stories attracted more than 600 views during the weekend and nearly 1000 engagements on social media during the launch itself.

We thank all those organisations such as ARTP, ARNS and ACPRC, individual healthcare professionals and patient groups such as Pathfinders who supported us this year, and we hope to expand the reach next May when we’re planning some new ways for patients and healthcare professionals to engage with World HMV Day.

We believe that it is crucial to raise awareness of HMV and how it can benefit patients with conditions that damage the lungs, such as COPD and also conditions that restrict the movement of air in and out of the body, including Motor Neurone Disease, Duchenne Muscular Dystrophy and many other neuromuscular conditions.

In the case of COPD, studies[1] have clearly demonstrated improved symptoms and reduced COPD exacerbations that may otherwise result in a hospital admission. These studies include a UK based trial called the HOT-HMV trial[2] which showed some important results for patients. Significantly those patients who received the HMV treatment remained out of hospital for an average of 90 days longer than those patients in the study that did not receive HMV. They were also approximately 50% less likely to be readmitted to hospital in the following year.

The reduction in hospital admissions and number of COPD exacerbations means that HMV therapy in this group of patients could also save the healthcare system money. UK and international guidance on how best to manage COPD patients now recommend that HMV be offered to appropriate patients with COPD.

The HMViP Group want those patients who would benefit from using HMV to be aware of the advantages of this treatment, which may include maintaining independence and improving quality of life. We therefore aim to provide an innovative, informative, digital platform on home ventilation to improve the experience of patient conditions which benefit from HMV, their family and carers, as well as supporting clinicians.

We have structured our work so that we have a phased approach and are continually working to add new content to the website.  We recently added neuromuscular conditions, OHS and paediatric to adult transition services to support the launch of World HMV Day.

We encourage your feedback from clinicians on how we can develop and improve the website content to support you and your patients. As part of this ongoing evaluation, we surveyed last year’s HMV-UK audience to ask what content you’d like to see on the website, and our next phase of work will reflect the feedback that we received. As a result, we’ll be looking at content around tracheostomy ventilation, end of life care and secretion management, among other topics.

In addition, we’re working on a leaflet which you can give to patients and also a poster to be displayed in clinics and ward areas to signpost more users to our website, as well as looking at other ways we can support improved HMV education and encourage more NHS trusts to offer this important service to their patient population.

We very much value your support for the HMViP Group, welcome your feedback and hope to see your support for World HMV Day in 2024.

Visit https://hmvip.co.uk/ to find out more.

 

[1] https://hmvip.co.uk/research-and-evidence

[2] HMV (Home Mechanical Ventilation) with HOT (Home Oxygen Therapy) Trial, St Thomas’s Hospital, London

https://erj.ersjournals.com/content/52/suppl_62/PA1679