To pilot the methods and evaluate the feasibility of EncoreAnywhere telemonitoring within a randomised controlled trial. 

To explore the levels and patterns of adherence and ventilation effectiveness during the initiation phase of non-invasive ventilation (NIV).

NIV improves survival in patients with motor neurone disease (MND) who develop respiratory failure. Initiation of NIV can be difficult and lack of adherence to treatment worsens outcomes. Telemonitoring, which collects data on NIV adherence and ventilation remotely, may be beneficial in promoting effective NIV use.

All patients with MND commencing home NIV for respiratory failure were included and had an EncoreAnywhere modem installed on their NIV machine. Patients were randomised to receive either usual care or usual care plus intervention. The respiratory physiologist could review the EncoreAnywhere data of intervention group during the three-month trial. Data collected automatically using EncoreAnywhere included adherence patterns, tidal volume and ventilator settings. 

Of 21 eligible patients, 19 (90%) were recruited (53% female, 10 intervention, 41-85 years). Mean ALSFRS-R score was 24.6(13-39). The study and the intervention were found to be acceptable; no withdrawals occurred. The average NIV use at three months was 3.56 ± 1.05 hrs/day (SD=4.06, range=0-9.72 hrs/day). 13 patients (68%) reached an adherence of at least 4 hours per day, taking a mean of six days to reach this level. However, only six out of 15 patients alive at three months maintained this adherence. 

We identified ways in which EncoreAnywhere could promote NIV including provision of reliable real-time monitoring and promotion of patient adherence and adjustment of ventilator settings remotely to promote patient comfort and optimise ventilation. 

EncoreAnywhere is an acceptable and feasible way to support initiation and sustain use. We need a better understanding of the most effective way to use EncoreAnywhere to gain best results. A large randomised controlled trial is feasible and promising.