‘It is not going to change his life but it has picked him up’: a qualitative study of perspectives on long term oxygen therapy for people with chronic obstructive pulmonary disease

Abstract

BackgroundLong-term oxygen therapy (LTOT) extends life in patients with chronic obstructive pulmonary disease with severe hypoxaemia. Questionnaire-based studies of the effects of LTOT have not suggested uniformly positive findings. The few qualitative studies suggest that patients report benefits but also concerns about dependency on oxygen therapy. The aim of the study was to explore the views and experiences of COPD patients, their carers and the healthcare professionals who deliver these services, on the long-term use of oxygen therapy.MethodsFocus groups were conducted with 16 patients with from the LTOT service, six carers, and nine healthcare professionals (n = 31). Eleven patients with COPD, four carers and one staff manager (n = 16) participated in semi-structured interviews. Interviews and focus group were digitally recorded and field notes were taken. Data were analysed using the thematic network analysis approach.ResultsPatients and carers reported the benefits of LTOT including increased social activity, perceived improvements in health status and self-management in routine daily activities. Concerns were raised regarding stigma, dependency on LTOT and deterioration in health status. Staff accounts included negative perceptions, suggesting that LTOT was often inappropriately prescribed and under-used but recommended active patient management to address this challenge.ConclusionsLTOT has some beneficial effects in improving daily activities and social interaction of patients with COPD but also some limitations. Increased support and monitoring by healthcare professionals would address some concerns, as would better information for patients, carers and the general public.

Caregivers' Perspectives on the Use of Long-Term Oxygen Therapy for the Treatment of Refractory Breathlessness: A Qualitative Study

“…Yet our study has shown that, to a large extent, caregivers consider oxygen to have a significant role in the relief of refractory breathlessness. These findings are supported by those by Goldbart et al who found that caregivers equated LTOT as important for patients' quality of life [17]. Our findings go much further however, highlighting how LTOT, to a large extent was regarded by caregivers as critical in keeping the person they are caring for alive.…”

British Thoracic Society guidelines for home oxygen use in adults: accredited by NICE

“…Randomisation of 122 LTOT patients to follow-up with a hospital-based homecare programme (monthly phone call, home visits every 3 months, and home or hospital visits on a demand basis) or conventional medical care, demonstrated significantly decreased costs in the homecare follow-up group, which was mainly due to a reduction in use of hospital resources, despite the cost of running the service itself 59. Reports from focus groups60 and case series53 highlight the importance of education from specialist nurses or physiotherapists in increasing compliance and addressing patient concerns.…”

Informal caregivers experience of supplemental oxygen in pulmonary fibrosis

“…Similar studies were conducted on ICs of patients with COPD [7, 8], but to our knowledge, this is the first study to focus on the impact of O 2 on ICs of PF patients.…”