HIQA launches new HTA on home mechanical ventilation for adults with spinal cord injuries

HIQA has begun work on a health technology assessment (HTA) reviewing domiciliary (at home) invasive ventilation for adults with spinal cord injuries. HIQA has published the protocol that outlines the approach it will use to complete this work.

HIQA agreed to undertake this HTA following a request from the National Clinical Programme for Rehabilitation Medicine in the Health Service Executive (HSE) and the Spinal Cord System of Care Programme in the National Rehabilitation Hospital (NRH).

A spinal cord injury involves damage to the spinal cord that causes changes in its function, which can be either temporary or permanent. Damage to the spinal cord can be life-threatening or result in life-changing injuries, with the potential for long-term disability. The higher up the spinal cord the injury occurs, the more serious the symptoms will be. Given the extent of these injuries, affected individuals often have complex healthcare needs and generally require lifelong assistance with many aspects of their life.

While most individuals with high spinal cord injuries will require a ventilator initially, only a very small number will require it permanently. For these individuals, there is often a preference to receive care at home rather than staying in a hospital. HIQA’s latest HTA focuses on the small number of individuals with spinal cord injuries who require lifelong invasive ventilation and in whom discharge home is deemed appropriate by their medical team.

Dr Conor Teljeur, HIQA’s Chief Scientist, said: “In line with the ambitions of Sláintecare, there is a desire to move care out of acute hospitals and into the community, closer to people’s homes, when it is safe to do so. However, up until now, organisation of home mechanical ventilation services for ventilator-dependent individuals with spinal cord injuries in Ireland has been on a case-by-case basis, contributing to a significant administrative burden and delays in service provision.”

The HTA will assess the organisational, budget impact and resource implications, as well as the social and ethical issues arising from the provision of care to these individuals within their own home. The findings of the assessment will inform a decision by the HSE on the national delivery of care.