Supplementary Material for: Home Use of Mechanical Insufflation/Exsufflation in Adult Patients in Western Switzerland

<b><i>Background:</i></b> Mechanical insufflation/exsufflation (MI-E) devices are often prescribed to patients with inefficient cough and recurrent infections, but their use in the home setting is not well characterized. <b><i>Objective:</i></b> The objective of this study was to report a real-life experience and identify factors that are associated with home MI-E use in adult patients. <b><i>Methods:</i></b> This is a cross-sectional observational study of adult subjects with neurological disease using MI-E at home for more than 3 months. <b><i>Results:</i></b> A total of 43 patients were included. Median age (interquartile range) was 48 (31–64) years. The most common diagnosis was muscular dystrophy (<i>n</i> = 15), followed by multiple sclerosis (<i>n</i> = 7) and amyotrophic lateral sclerosis (<i>n</i> = 7). 24 subjects (56%) reported using the MI-E at least once weekly. Based on device data downloads, the median objective use was 23% of days analysed (approximately 2 times per week). The vast majority (94%) of all participants reported using the device at least daily during an infectious episode, while 62% reported having used the device in emergency situations such as bronchoaspiration. Reported use correlated well with objective use (<i>r</i> = 0.82). Most subjects reported an improvement in their respiratory health (64%) and were satisfied with the device (78%). Higher reported and objective use were associated with increased symptoms (<i>p</i> = 0.001) and higher satisfaction with the device (<i>p</i> = 0.008). We found no association between frequency of use and baseline cough peak flow (CPF), bulbar impairment, non-invasive ventilation use, living environment, or supervised administration. <b><i>Conclusion:</i></b> Regular home MI-E use was associated with greater symptom burden and overall satisfaction with the device and was not influenced by baseline CPF. Patients without substantial bronchorrhea might not use the MI-E regularly but might still need to use the device at home during acute events. Therefore, familiarity with the MI-E via appropriate and repeated practical training is crucial.