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Oxygen... there's something in the air

Chronic obstructive pulmonary disease (COPD) affects approximately 24 million people in the United States and leads to over 800,000 hospitalizations each year.  In people with COPD who have hypoxemia, clinical trials have shown that using supplemental oxygen can benefit quality of life, activity tolerance, and longevity.  The benefits of supplemental oxygen have been shown to increase with the hours of use per day, leading to fewer hospitalizations and improved quality of life for those who use oxygen for at least 15 hours per day.  Unfortunately, despite evidence indicating improved quality of life and decreased healthcare utilization associated with adherence to supplemental oxygen, rates of adherence are typically below 50%.  While non adherence to any therapy is multifactorial, supplemental oxygen use can prove especially difficult due to cumbersome equipment, lack of proper instruction for use, and stigma associated with use. 

During this podcast, we discuss the current evidence for supplemental oxygen use, documentation of the oxygen prescription, safety, and the patient perspective of using supplemental oxygen, as well as how clinicians can help promote adherence in their patients.

Thanks for listening!

Nina Bracken, MSN, ACNP-BC
Susan Jacobs, RN, MS
Min Joo, MD, MPH
Edna Shattuck, RN, RRT

 

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References:

  1. Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: A clinical trial. Nocturnal Oxygen Therapy Trial Group. Annals of Internal Medicine. 1980. 93(3):391-8. 

  2. Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. The Lancet. 1981 Mar 28; 1(8222):681-6. 

  3. Qaseem A, Wilt TJ, Weinberger SE, Hanania, NA, Criner G, van der Molen T, Marciniuk DD, Denberg T, Schunermann H, Wedzicha W, MacDonald R, Shekelle P. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Ann Intern Med. 2011; 155(3):179-91.

  4. Drummond MB, Blackford AL, Benditt JO, Make BJ, Sciurba FC, McCormack MC, Martinez FJ, Fessler HE, Fishman AP, Wise RA; NETT Investigators. Continuous oxygen use in nonhypoxemic emphysema patients identifies a high-risk subset of patients: retrospective analysis of the National Emphysema Treatment Trial. Chest. 2008;134(3):497–506. 

  5. Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema: Report of the Medical Research Council Working Party. The Lancet. 1981; 1(8222):681-6.

  6. Oba Y: Cost-effectiveness of long-term oxygen therapy for chronic obstructive pulmonary disease. Am J Manag Care. 2009; 15:97-104.