Clinical Research Directory

Inclusion Criteria: 1. Age between 50 and 90 years. 2. Confirmed diagnosis of Chronic Obstructive Pulmonary Disease (COPD) according to current Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, demonstrating non-fully reversible airflow limitation with a Forced Expiratory Volume in 1 second (FEV1) \< 50% of the predicted value confirmed by spirometry. 3. Persistent hypercapnia, defined as PaCO2 \> 53 mmHg documented for at least two weeks following an acute COPD exacerbation. 4. History of two or more acute COPD exacerbations within the preceding year. 5. Signed written informed consent. Exclusion Criteria: 1. Prior ongoing treatment with home non-invasive ventilation (NIV) or Continuous Positive Airway Pressure (CPAP). 2. Severe obstructive sleep apnea (OSA), defined as an Apnea-Hypopnea Index (AHI) \>= 30. 3. Inability of the patient or the primary caregiver to comprehend or operate the telemonitoring and NIV procedures. 4. Estimated life expectancy of less than one year. 5. Terminal heart failure (New York Heart Association \[NYHA\] Class III-IV) or unstable angina. 6. Advanced renal insufficiency (creatinine clearance \< 30%) or inclusion in an active dialysis program. 7. Hepatic cirrhosis or active inclusion in a liver transplant program. 8. Severe psychiatric illness requiring antipsychotic medication, active ongoing treatment for substance or alcohol addiction, or lack of a fixed home address upon hospital discharge. 9. Receipt of home palliative care. 10. Institutionalization. 11. Classification by the attending physician as non-compliant with medical therapies, treatments, or study protocols