Reducing COPD exacerbations and readmissions with non-invasive ventilation

Home NIV for COPD

In 2012, more than one million COPD patients experienced an acute exacerbation that resulted in hospitalization.1

At $11,195 per average admission, the estimated cost to the U.S. healthcare system is more than $49 billion dollars

annually.1 Furthermore, approximately 22% of these patients are readmitted within 30 days of discharge.2 Each

hospitalization places a tremendous burden on COPD patients and their families.

In order to address these costs, Medicare has added COPD to the list of diagnoses targeted for reductions in

readmissions with a penalty of 3%. Hospitals, insurance providers, care providers and patients are looking for better

solutions for the long-term care of COPD patients.3

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Compliance Report

30 day compliance 06/10/2011 - 07/09/2011

Compliance met Yes

Compliance percentage 86%

Usage 06/10/2011 - 07/09/2011

Usage days 28/30 days (93%)

>= 4 hours 26 days (86%)

< 4 hours 2 days (7%)

Usage hours 174 hours 42 minutes

Average usage (total days) 5 hours 49 minutes

Average usage (days used) 6 hours 14 minutes

Median usage (days used) 6 hours 24 minutes

S9 AutoSetSerial number 42102071722

Mode AutoSet

Min Pressure 4.0 cm H O

Max Pressure 20 cm H O

EPR Off

EPR Level 0

TherapyPressure - cm H O Median: 9.7 95th percentile: 12.0 Maximum: 13.5

Leaks - L/min Median: 0.0 95th percentile: 2.4 Maximum: 12.6

Events per hour AI: 0.6 HI: 0.2 AHI: 0.8

Apnea Index Central: 0.0 Obstructive: 0.6 Unknown: 0.0

Usage - Hours

Abshire, Odessa06/10/2011 - 07/09/2011ID: 04806065DOB: 06/05/1975Age: 36 yearsGender: Female

Sleep Distributor LLC NU942 High FreewaySouthmouthNunavut,68841

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Phone: (500)071-7534 x58271Fax: 660-726-4829 x9795Email: admin@sleepdistributorllcnu.com

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THERAPY REPORT

Printed on 5/25/2012 - ResMed EasyCare Online version 1.2

USAGE AND COMPLIANCE REPORT

Why NIV for COPD?If COPD sufferers are admitted to the hospital due to an acute exacerbation, they are often placed on non-invasive

ventilation (NIV.) However, once they are discharged, they continue with their standard therapy of pharmacology

and/or oxygen. Oxygen therapy addresses hypoxemia caused by impaired gas exchange in the lung tissue (type

1 respiratory failure); however, unlike NIV, it does not address hypercapnia caused by ventilatory failure (type 2

respiratory failure). By adding NIV to your standard care regimen, you may be able to effectively treat both types

of respiratory failure in your COPD patients.

Research shows that the use of NIV at home:

• Reduces mortality in patients with COPD by 76%4

• Reduces admissions and minimizes costs for hospitals5

• Reduces recurrence of acute hypercapnic respiratory failure following an initial event by 60.2% in the first

30 days following the event when compared to CPAP (38.5%)6

• May lead to an improved quality of life7, 8

Despite clinical evidence that NIV may improve health outcomes associated with COPD,

NIV is still not often considered for chronic care.

Data monitoring for successful patient follow-up Due to the likelihood of rehospitalization following an acute

exacerbation, it’s important for care providers to monitor and

provide follow-up care for COPD patients post-discharge.

In fact, research shows that monitoring the breathing rate of

hypercapnic COPD patients in home allows early identification

of COPD exacerbations.9

With AirView™, ResMed’s cloud-based data management

system, you can view critical ventilation data and key metrics

such as respiratory rate and minute ventilation to

determine if patients are in distress or

at an increased risk for an acute

exacerbation – particularly

in the critical 30 days

post-hospital discharge.

Patient identity and corresponding data used are fictional.

ResMed’s NIV therapy solutionsOur home NIV solutions are focused on helping reduce acute exacerbations of COPD and hospital readmissions.

With our sophisticated range of comfortable, effective therapy and tools, we can guide you in the long-term

management and ventilation care of your COPD patients.

With our sophisticated NIV technologies, you can be confident that your patients are receiving comfortable, effective and synchronized treatment from their ResMed device.

Improved O2 delivery and ventilation monitoringIntegrated FiO2 monitoring in Astral 150 allows you to prescribe concentrations (e.g.FiO2) of oxygen, which are more precise than liter flows (e.g. LPM), in addition to the option of integrated oximetry for objective patient monitoring.

iVAPS: Unlike other ventilation modes that only target tidal volume, iVAPS targets a unique minute ventilation algorithm, which accounts for anatomical dead space, to ventilate patients more effectively.

TiControl™: For patients who experience challenges in exhaling, a shortened Ti Max (maximum time spent in inspiration) will allow for longer exhalation time and may provide better comfort and less likelihood of air trapping or intrinsic PEEP.

Trigger/cycle sensitivity: Adjustable trigger and cycle sensitivities allow further customization at the beginning and end of each inspiration, which further improves patient-device synchronization.

AirCurve™ 10 ST-A

Our premium homecare device is optimized to treat COPD using the latest volume-

assured pressure support technology, iVAPS.™ This technology responds to respiratory

rate, targets alveolar ventilation and automatically adjusts pressure support as

needed to accommodate the patient’s needs, even as their disease progresses.

Astral™ 100/150

For more advanced clinical needs, our Astral life support ventilator offers a broad

range of therapy modes and features to optimize the treatment of your COPD

patients. With unique synchrony features that maximize expiratory time and

integrated FiO2 monitoring in Astral 150 that lets you fine-tune oxygen delivery, Astral

offers the quality of life benefits that are so important to chronically ill COPD patients.

AirView

AirView, our cloud-based data management system, is available for both Astral

and AirCurve 10 ST-A devices. AirView can help both physicians and home medical

equipment providers (HMEs) by providing daily access to key patient data,

enabling efficient collaboration and coordinated patient care.

• Access key ventilation parameters, such as usage, AHI, tidal volume,

minute ventilation and respiratory rate

• Allows for early patient intervention before a potential problem or

hospitalization occurs

• Provides consistent care for COPD patients by standardizing routine

home monitoring

Patient identity and corresponding data used are fictional.Distributed by ResMed Corp, 9001 Spectrum Center Boulevard, San Diego, CA 92123 USA +1 858 836 5000 or 1 800 424 0737 (toll free). See ResMed.com for other ResMed locations worldwide. AirCurve, AirView, Astral, iVAPS and TiControl are trademarks and/or registered trademarks of the ResMed family of companies. Specifications may change without notice. © 2017 ResMed. 1019069/4 2017-02

Just like you, our goal is to help COPD patients enjoy a better quality of life. Visit ResMed.com/NIVforCOPD to learn how implementing a home NIV program can help you manage your patients’ treatment so they can get the most out of each day.

1 Perera PN et al. Acute exacerbations of COPD in the United States: inpatient burden and predictors of cost and mortality. COPD 2012;9:131– 44.2 Jencks S F et al. Rehospitalizations among patients in the Medicare fee-for-service program. New Engl J Med 2009;360(14): 1418-28. 3 Boutwell A. Time to get serious about hospital readmissions. Health Affairs Blog, October 12, 2012.

http://healthaffairs.org/blog/2012/10/10/time-to-get-serious-about-hospital-readmissions (accessed November20, 2014).4 Köhnlein T 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 Sep;2(9):698-705.5 Tuggey JM, Plant PK and Elliott MW. Domiciliary non-invasive ventilation for recurrent acidotic exacerbations of COPD: An economic analysis. Thorax 2003;58(10):867–71.6 Cheung AP et al. A pilot trial of non-invasive home ventilation after acidotic respiratory failure in chronic obstructive pulmonary disease. Int J Tuberc Lung Dis 2010;14:642–9.7 Tsolaki et al. One-year non-invasive ventilation in chronic hypercapnic COPD: Effect on quality of life. Respir Med 2008;102(6):904–11.8 Duiverman ML et al. Nocturnal non-invasive ventilation in addition to rehabilitation in hypercapnic patients with COPD. Thorax 2008;63(12):1052–7.9. Yanez et al. Monitoring breathing rate at home allows early identification of COPD exacerbations. Chest 2012; 142 (6): 1524-9

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