At Home and on Demand Mechanical Cough Assistance Program for Patients With Amyotrophic Lateral Sclerosis

• DOI: 10.1097/phm.0b013e3181d89760
• Publication Date: 2010-04-14T07:07:07Z
• Authors: Michele Vitacca; Mara Paneroni; Debora Trainini; Luca Bianchi; Giuliano Assoni; Manuela Saleri; Sonia Gilè; João C. Winck; Miguel R. Gonçalves
• Keywords: Pulmonologists

To establish a cost-effective telephone-accessed consultation and mechanical in-exsufflation (MI-E) manually assisted coughing, oximetry feedback program for 39 patients with amyotrophic lateral sclerosis.Rapid access to healthcare MI-E was provided treat episodes of distress as result secretion encumbrance not reversed by suctioning associated decrease in oxyhemoglobin saturation (SpO(2)) baseline. Avoided hospitalizations, defined relief respiratory return SpO(2) baseline >or=95% continuous ventilator use were recorded. Patient satisfaction queried at 6 mos, cost analysis performed vs. on demand use.Thirty-nine made total 1661 calls 7.46 +/- 5.8 mos follow-up. Twenty-seven had 66 home care visits therapist time commitment 89.7 99.3 min/patient/mo. Twelve patients, all users, also brought in-exsufflators mechanically coughing 47 episodes. Thirty hospitalizations avoided. Seventy-five percent the extremely satisfied. Mean monthly per patient on-demand telephone consultation, professional visits, deemed necessary euro403 euro420 or 59% less than rental. Hospitalization costs spared.An consult can avoid sclerosis significant savings.