Optimizing Home Oxygen Therapy. An Official American Thoracic Society Workshop Report

Jacobs, Susan S.; Lederer, David J.; Garvey, Chris; Hernández, Carme; Lindell, Kathleen O.; McLaughlin, Sally; Schneidman, Ann M; Casaburi, Richard; Chang, Valerie; Cosgrove, Greg P; Devitt, Laura; Erickson, Karen L.; Ewart, Gary; Giordano, Sam P; Harbaugh, Mary; Kallstrom, Thomas J; Kroner, Katherine; Krishnan, Jerry A.; Lamberti, James; Porte, Phillip; Prieto-Centurion, Valentin; Sherman, Susan E.; Sullivan, Jamie; Sward, Erika; Swigris, Jeffrey J.; Upson, Dona

doi:10.1513/annalsats.201809-627ws

Cited by 53 publications

(37 citation statements)

References 16 publications

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“…The long-term benefits of oxygen have been proven since the 1980s in certain respiratory conditions such as COPD. Very recently, future research in oxygen therapy has been pointed at developing and evaluating new models for therapeutic oxygen patient education and improving portable oxygen devices [53]. It has been reported that, when compared to the conventional POCs, the closed-loop POCs can maintain higher saturation levels, spend less time below the target saturation, and save O 2 resources [25].…”

Section: Discussionmentioning

confidence: 99%

Automated Home Oxygen Delivery for Patients with COPD and Respiratory Failure: A New Approach

Morillo

Muñoz-Zara

Lara-Doña

et al. 2020

Sensors

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Long-term oxygen therapy (LTOT) has become standard care for the treatment of patients with chronic obstructive pulmonary disease (COPD) and other severe hypoxemic lung diseases. The use of new portable O2 concentrators (POC) in LTOT is being expanded. However, the issue of oxygen titration is not always properly addressed, since POCs rely on proper use by patients. The robustness of algorithms and the limited reliability of current oximetry sensors are hindering the effectiveness of new approaches to closed-loop POCs based on the feedback of blood oxygen saturation. In this study, a novel intelligent portable oxygen concentrator (iPOC) is described. The presented iPOC is capable of adjusting the O2 flow automatically by real-time classifying the intensity of a patient’s physical activity (PA). It was designed with a group of patients with COPD and stable chronic respiratory failure. The technical pilot test showed a weighted accuracy of 91.1% in updating the O2 flow automatically according to medical prescriptions, and a general improvement in oxygenation compared to conventional POCs. In addition, the usability achieved was high, which indicated a significant degree of user satisfaction. This iPOC may have important benefits, including improved oxygenation, increased compliance with therapy recommendations, and the promotion of PA.

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Section: Discussionmentioning

confidence: 99%

Automated Home Oxygen Delivery for Patients with COPD and Respiratory Failure: A New Approach

Morillo

Muñoz-Zara

Lara-Doña

et al. 2020

Sensors

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“…Patients report problems concerning oxygen supply, low portability of equipment and lack of experienced and dedicated assistance. Moreover, physicians report issues related to long-term home oxygen prescriptions [ 66 ]. In particular, prescriptive models rely on values of arterial oxygen tension to assess oxygen demand, without considering a real titration according to oxygen saturation measured by pulse oximetry.…”

Section: The Burden Of Respiratory Treatmentsmentioning

confidence: 99%

“…This leads to possible under/over-estimation of oxygen need with negative clinical impacts such as disease exacerbations and emergency department admissions, and adverse economic consequences [ 67 ]. Finally, due to the current bidding system, oxygen providers cut their financial resources, equipment and staff, in order to survive in a very competitive market [ 66 ]. Consequently, the oxygen on offer in countries may be limited, causing discomfort for patients affected by chronic respiratory failure [ 65 ].…”

Section: The Burden Of Respiratory Treatmentsmentioning

confidence: 99%

“…An American Thoracic Society workshop referred to this as the “oxygen supplementation crisis” and recommended using a coordinated multidisciplinary and data integration approach to change the current policy, and improve assistance to patients and outcomes. More research is needed to understand how to solve this “crisis” and guide clinical practice [ 66 ].…”

Section: The Burden Of Respiratory Treatmentsmentioning

confidence: 99%

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Patient's treatment burden related to care coordination in the field of respiratory diseases

Pierucci

Santomasi

Ambrosino

et al. 2021

Breathe

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The management of respiratory diseases requires various levels of care: multidisciplinary teams, educational and behavioural interventions, self-management and home-based technical support are vital to ensure adequate care management. However, it is often difficult to access these networks due to fragmentation of patient care and treatment burden. Care coordination aims to ensure patients have a central role and that there is continuity of care among various levels and professionals involved. Moreover, the coronavirus disease pandemic has caused strain on the global healthcare system, with care coordination becoming increasingly important in increasing the resilience of health systems, supporting healthcare professionals and ensuring the right treatment and adequate level of care for these patients.

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“…This option, however, is more costly and not always available through providers in the patient's geographic area. Clinicians should be aware of these potential problems and work collaboratively with durable medical equipment companies to provide equipment that matches patient needs [85].…”

Section: Role Of Palliative Care In Symptom Managementmentioning

confidence: 99%

The Role of Palliative Care in Reducing Symptoms and Improving Quality of Life for Patients with Idiopathic Pulmonary Fibrosis: A Review

et al. 2020

Self Cite

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Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease with a median survival of 3-4 years from time of initial diagnosis, similar to the time course of many malignancies. A hallmark of IPF is its unpredictable disease course, ranging from long periods of clinical stability to acute exacerbations with rapid decompensation. As the disease progresses, patients with chronic cough and progressive exertional dyspnea become oxygen dependent. They may experience significant distress due to concurrent depression, anxiety, and fatigue, which often lead to increased symptom burden and decreased quality of life. Despite these complications, palliative care is an underutilized, and often underappreciated, resource before end-of-life care in this population. While there is growing recognition about early palliative care in IPF, current data suggest referral patterns vary widely based on institutional practices. In addition to focusing on symptom management, there is emphasis on supplemental oxygen use, pulmonary rehabilitation, quality of life, and end-of-life care. Importantly, increased use of support groups and national foundation forums have served as venues for further disease education, communication, and advanced care planning outside of the hospital settings. The purpose of this review article is to discuss the clinical features of IPF, the role of palliative care in chronic disease management, current data supporting benefits of palliative care in IPF, its role in symptom management, and practices to help patients and their caregivers achieve their best quality of life.

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Optimizing Home Oxygen Therapy. An Official American Thoracic Society Workshop Report

Cited by 53 publications

References 16 publications

Automated Home Oxygen Delivery for Patients with COPD and Respiratory Failure: A New Approach

Automated Home Oxygen Delivery for Patients with COPD and Respiratory Failure: A New Approach

Patient's treatment burden related to care coordination in the field of respiratory diseases

The Role of Palliative Care in Reducing Symptoms and Improving Quality of Life for Patients with Idiopathic Pulmonary Fibrosis: A Review

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