SEPAR year of the chronic patient and domiciliary respiratory care. Points for reflection.

The Spanish Society of Pneumology and Thoracic Surgery (SEPAR) has declared 2014 the Year of the Chronic Patient and Domiciliary Respiratory Care (DRC). The initiative could not be timelier, as DRC is the focus of important new concepts associated with advances in health technology and the design of new models of relationships between patients, professionals, administrators and service providers. Archivos de Bronconeumología joins this initiative with the inauguration of a series of reviews by expert authors addressing the major current issues in DRC. A marked increase in the demand for DRC is expected in the coming years, in view of demographic changes, the increase in chronic and disabling disease and the widening variety of patient care settings other than hospitals (nursing homes, centers for chronic patients, home). Advances in chronic respiratory failure and the need for home oxygen therapy (HOT) led to a change in strategy in the 1980s and the creation of an infrastructure and service network capable of responding to specific needs. Following Sullivan’s description of the nasal application of positive pressure (CPAP) in patients with sleep apnea-hypopnea syndrome (SAHS) and the improvement of interfaces, the use of noninvasive ventilation (NIV) became generalized.1,2 There is evidence that patients with COPD survive longer on continuous oxygen therapy (COT),3 and CPAP has also been shown to control the symptoms of patients with SAHS, to reduce associated traffic accidents, and to impact positively on cardiovascular comorbidity.1 Although no controlled clinical trials are available, home-based mechanical ventilation (HMV) reduces the need for hospitalization and improves life expectancy in many situations of chronic respiratory failure.4 Nebulized antibiotic therapy is a frontline weapon in the prevention of bronchial infections in patients with cystic fibrosis and adults with bronchiectasis.5 In short, DRC methods