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• W3204996836 abstract "TOPIC: Obstructive Lung Diseases TYPE: Original Investigations PURPOSE: The COVID-19 pandemic has caused the Centers for Medicare and Medicaid Services (CMS) to institute temporary changes that increase flexibility for physicians to determine the medical need for respiratory devices, such as High Frequency Chest Wall Oscillation (HFCWO or vest therapy). Since early 2020, many patients have received vest therapy who would not otherwise qualify through this waiver program, but the effectiveness of HFCWO therapy for this population has not been reported. METHODS: The self-reported hospitalization patterns and metrics of subjective airway clearance experience were assessed before and after initiation of HFCWO therapy in a cohort of patients who had received the devices under the CMS waiver. Data were drawn from the HFCWO Outcomes Registry (HFCWO-OR), including patients with a wide variety of primary diagnoses but all had difficulty clearing airway secretions. All patients in this study received the Philips InCourage vest therapy system. The primary outcomes were self-reported hospitalization rate and two survey questions related to airway clearance. RESULTS: 901 patients met inclusion criteria for being covered under the CMS waiver program, average age 72.8+10.7. Within this group, there were 89 unique primary diagnoses, principally COPD (58.9%), bronchiectasis (8.6%), and bronchitis (6.7%). Only a small proportion of these patients had a diagnosis of COVID-19 (1.7%). In the 12-month interval prior to initiating HFCWO therapy, the number of patients with zero self-reported hospitalizations was 54.0% (Cl. 50.7%, 57.3%), compared with 86.6% (Cl. 79.2%, 94.0%) of patients who reported zero hospitalizations in the subsequent 6 months. There was an overall 69.0% reduction in the annualized hospitalization rate after 6 months (0.279 hospitalizations/patient/year at 6 months, compared to 0.865 hospitalizations/patient/year prior to initiating vest therapy) (p<0.0001). Those patients who subjectively rated their overall respiratory health as good, very good, or excellent increased from 19.0% upon initiation of therapy to 57.3% within 6 months. (p<0.0001). Those who rated the ability to clear your lungs as good, very good, or excellent increased from 14.7% upon initiation of therapy to 61.3% within 6 months. (p<0.0001). CONCLUSIONS: A large number of patients have received HFCWO therapy under CMS's temporary flexibility in reimbursement policies who would not normally have received coverage. This study shows that outcomes for these patients, as measured by self-reported hospitalizations, respiratory health, and the ability to clear secretions, improved substantially after the initiation of HFCWO therapy. These improvements were sustained for at least six months. Our results were remarkably similar to outcomes for currently covered diagnoses (e.g., bronchiectasis). CLINICAL IMPLICATIONS: HFCWO therapy is associated with positive outcomes in CMS waiver patients. DISCLOSURES: Consultant relationship with Respirtech Technologies Please note: $5001 - $20000 by Tara Barto, source=Web Response, value=Consulting fee No relevant relationships by Sarah Daignault, source=Web Response Employee relationship with RespirTech Please note: 2015-Present Added 04/16/2021 by Gary Hansen, source=Web Response, value=Salary No relevant relationships by Frederic Seifer, source=Web Response" @default.
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• W3204996836 date "2021-10-01" @default.
• W3204996836 modified "2023-09-27" @default.
• W3204996836 title "SELF-REPORTED OUTCOMES FROM PATIENTS USING VEST THERAPY THROUGH THE COVID-RELATED REIMBURSEMENT CHANGES" @default.
• W3204996836 doi "https://doi.org/10.1016/j.chest.2021.07.1632" @default.
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