Abstract
This study aimed to investigate the impact of adherence to non-invasive ventilation (NIV) on the prognosis of patients with overlap syndrome (OS). This retrospective cohort study included 115 hospitalised patients with OS who initiated home NIV therapy and were followed up for 12 months. Adherence was classified as good (≥4 h/d) or poor (p p p = 0.041), but did not affect the severity of exacerbations. SGRQ scores at 6 and 12 months were better in the good adherence group (p < 0.05). There were no differences between groups in eosinophil counts or the use of benzodiazepines and opioids. This study demonstrates that good adherence to home NIV therapy following AECOPD significantly delays time to first exacerbation and reduces annual exacerbation frequency in patients with OS, while improving health-related quality of life. Additionally, in-hospital NIV initiation was associated with higher rates of home NIV acceptance compared to outpatient initiation, though this secondary finding requires prospective validation with appropriate comparator groups. These findings support the implementation of systematic screening and early intervention strategies for OS patients hospitalised for AECOPD.