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Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease

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Home Care for Bronchiolitis: A Systematic Review.

Joanna Lawrence^1,2,3,4, Ramesh Walpola⁴, Suzanne L Boyce^1,5,6

¹Hospital in the Home.

|September 6, 2022

Summary

Hospital-at-Home (HAH) care for bronchiolitis, particularly home oxygen therapy (HOT), is feasible, acceptable, and safe for pediatric patients. Further research is needed to confirm cost-effectiveness and explore other HAH interventions.

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Area of Science:

Pediatric hospital admissions
Healthcare delivery models
Respiratory illness management

Background:

Bronchiolitis is a primary cause of pediatric hospitalizations.
Hospital-at-Home (HAH) offers hospital-level care in the patient's residence.
HAH models aim to alleviate hospital system strain.

Purpose of the Study:

To evaluate the feasibility, acceptability, and safety of HAH for treating bronchiolitis.
To assess the cost-impact of HAH on healthcare systems and society.
To review existing literature on HAH interventions for pediatric bronchiolitis.

Main Methods:

Systematic review of studies published in English since 2000.
Searched databases including Ovid Medline, Embase, Pubmed, Cochrane Library, CINAHL, and Web of Science.
Included randomized control trials, retrospective audits, and prospective observational trials.

Main Results:

Ten studies met inclusion criteria, focusing on home oxygen therapy (HOT).
HOT demonstrated feasibility (70%-82% uptake) and successful completion.
Seven adverse events (0.6%) and zero mortality were reported in 1257 patients.

Conclusions:

Home oxygen therapy (HOT) is a feasible, acceptable, and safe component of Hospital-at-Home (HAH) care for bronchiolitis.
Evidence for the cost-effectiveness of HAH remains limited.
Further research is recommended for HAH models involving nasogastric feeding and remote monitoring.