The development of new therapeutic strategies and the minimization
of both direct and indirect costs represent crucial goals in the
management of chronic diseases, particularly when these are
characterized by a high degree of disability.
Chronic respiratory insufficiency (CRI) represents an example of
a persistent disease worldwide, for which home management (i.e.,
daily nursing and treatment) was introduced more than two decades
ago according to traditional operating protocols. "Home long-term
oxygen treatment" (H-LTOT) was expected to produce significant
clinical improvements, together with a substantial drop in CRI
social costs (e.g., hospital admissions, number of exacerbations,
pharmaceutical costs, and patienta (TM)s reduced productivity).
The present volume describes the evolution in the home
management of severe CRI over the last two decades in Italy. It
reviews a range of topics including the epidemiological aspects,
complicating events, current systems for oxygen delivery with the
most convenient interfaces, changing approaches to the
patient--caregiver relationship, and the economic burden.
Particular attention is paid to the new trends in telemedicine,
which is regarded as the future step in respiratory medicine for
home-assisted and home-ventilated patients. Data concerning the new
role of nursing, the patienta (TM)s expectation of life, and the
patienta (TM)s, family's, and doctora (TM)s perspective are also
reported, together with an update on the economic impact of
telemedicine and the continuing improvements in the quality of
telematic H-OTLT.
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