FIG. 58: One other area of interest in HOT-HMV was exacerbation frequency. A potential result of home NIV is that patients have as many exacerbations, whether they are or are not allocated to home ventilation, but on home NIV they do not need to go to hospital because they have a home high-dependency unit with NIV, nebulized bronchodilators, and the use of antibiotics and oral steroids for a rescue pack that negate the need for hospital admission.

When we looked at the total admission and exacerbation numbers between the study groups, there was some suggestion that this might be the case, with a reduced number of admissions but an increased number of physician-treated exacerbations in the home ventilation group.[1] To account for this we averaged these occurrences per day to better indicate the exacerbation frequency.