COVID-19 pandemic effects on outcomes of patients in a provincial home ventilation program
Patients requiring long-term home non-invasive ventilation are a diverse group with different diagnoses leading to chronic respiratory failure. They are amongst the most vulnerable patients requiring home care due to their severe respiratory impairment. The Quebec National Program for Home Ventilatory Assistance (NPHVA) is a province-wide publicly funded program proving ventilators/BPAP machines and home respiratory care through Respiratory Therapists (RTs). Our aims are to 1)Determine the impact of the pandemic on care of NPHVA patients, by calculating hospitalizations and mortality during the pandemic compared to prior to the pandemic, by determining usage of ventilators/BPAP devices, and by comparing the number of monthly referrals to the program during the pandemic with that in the 2 years prior to the pandemic. We will look at whether there are differences in above measures based on: diagnostic category; gender; age categories (children, young to middle-aged adult, elderly); type of residence (long-term care, home); location of residence (urban, rural). 2) Understand the perception NPHVA patients have of the care they received during the pandemic, as individuals requiring a respiratory device. We want to understand challenges and facilitators of self-management in the pandemic. We will also study caregivers. Finally, we will ask RTs and doctors looking after these individuals about their perception of care of patients in the NPHVA. Data will be obtained from NPHVA records, from provincial databases and from questionnaires and interviews. This study will help us understand how the COVID‑19 pandemic has impacted provision of care in vulnerable individuals with chronic respiratory failure who depend on home care. With clearer data, we will be in a better position to identify potential targets for intervention to minimize impacts of any future waves of COVID-19, other pandemic or other major care disruptors.