{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:54:56Z","timestamp":1790355296044,"version":"4.1.0"},"reference-count":28,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Care"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>As knowledge of mechanical insufflation-exsufflation (MI-E) expands, understanding factors influencing home use is essential to promote effective therapy. This study aimed to determine the prevalence of MI-E long-term users in Norway and describe clinicians\u2019 self-reported experience and independence with MI-E, cough assessment practices, and MI-E initiation and follow-up in a country with over 20\u2009years of experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This cross-sectional study used 4 data sources (1) Norwegian Units for Medical Home-Care Equipment provided data on MI-E users, (2) Statistics Norway provided the overall count of the Norwegian population, (3) The Norwegian Patient Registry supplied population data on specialist health care service use, and (4) a survey of multidisciplinary clinicians collected self-reported data on clinicians MI-E confidence and practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In 2023, 1,131 individuals in Norway (16% under 18\u2009years) used MI-E devices for long-term treatment, with a prevalence of 53.5 per 100,000 among specialist health care service users and 20.6 per 100,000 in the total population. Of 182 survey respondents, 163 reported MI-E experience, primarily physiotherapists (78%), followed by nurses (13%) and physicians (9%). Physiotherapists had the longest experience and highest confidence in independently initiating MI-E and assisting colleagues. Most clinicians (77%) used multiple methods to assess cough effectiveness, including qualitative assessment, cough peak flow, and swallowing evaluation. Follow-up practices varied widely 43% used patient journals, 5% digital registries, 10% paper records, 27% unspecified overview of MI-E users for follow-up purposes, and 15% had no systematic overview. Regular follow-ups were reported by 43%, whereas 19% followed up only on patient request, 30% were unaware of local routines, and 8% reported no follow-up routines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The MI-E prevalence highlights its role as a substantial therapy for individuals with rare disorders. Variability in follow-up practices underscores the need for standardized guidelines to improve consistency and quality in long-term MI-E care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/respcare.12874","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T04:53:37Z","timestamp":1747371217000},"page":"1093-1102","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-Term Mechanical Insufflation-Exsufflation Practice: A Norwegian National Survey After More Than 20 Years\u2019 Experience"],"prefix":"10.1177","volume":"70","author":[{"given":"Tiina M.","family":"Andersen","sequence":"first","affiliation":[{"name":"Dr. Andersen is affiliated with Thoracic Department, Haukeland University Hospital, Bergen, Norway."},{"name":"Dr. Andersen is affiliated with The Department of Health and Functioning, Western Norway University of Applied Science, Bergen, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester","family":"N\u00f8rsteb\u00f8","sequence":"additional","affiliation":[{"name":"Ms. N\u00f8rsteb\u00f8 is affiliated with Clinic of Rehabilitation, St. Olavs Hospital, Trondheim, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brit","family":"Hov","sequence":"additional","affiliation":[{"name":"Ms. Hov is affiliated with Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30025-5"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2018.01.012"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2017.10.008"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-015-0267-0"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24614"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.09664"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2012-201964"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2017.11.004"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsmc.2024.04.009"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14797"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12072626"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07534"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.09263"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.04775"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2021-218410"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00754-2018"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.06321"},{"key":"e_1_3_6_19_2","volume-title":"Nasjonal veileder for langtids mekanisk ventilasjon (LTMV)","author":"Aarrestad S","year":"2012","unstructured":"Aarrestad S, , Fondenes O, , Fritzon L, et al. Nasjonal veileder for langtids mekanisk ventilasjon (LTMV). Helsedirektoratet: Oslo; 2012."},{"key":"e_1_3_6_20_2","unstructured":"Statistics and reports from The Norwegian Patient Registry (NPR) Norwegian Institute of Public Health. 2024: https:\/\/www.fhi.no\/he\/npr\/statistikk-og-rapporter\/"},{"key":"e_1_3_6_21_2","volume-title":"In 45th Nordic Lung Congress","author":"Andersen T","year":"2011","unstructured":"Andersen T, , Tollefsen E, , Fondenes O. Mechanical insufflation-exsufflation and mechanical ventilation in neuromuscular diseases in Norway (abstract). In 45th Nordic Lung Congress. Helsinki, Finland: Cabidigitallibrary.org; 2011."},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1159\/000529166"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmcr.2022.101649"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2015-207555"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.08960"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05924"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.09978"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00274-2023"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07682"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/respcare.12874","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/respcare.12874","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/respcare.12874","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:37:14Z","timestamp":1777685834000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/respcare.12874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,16]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1089\/respcare.12874"],"URL":"https:\/\/doi.org\/10.1089\/respcare.12874","relation":{},"ISSN":["1943-3654","1943-3654"],"issn-type":[{"value":"1943-3654","type":"print"},{"value":"1943-3654","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,16]]}}}