Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea.
Korean J Intern Med. 2022 Jan;37(1):119-126. doi: 10.3904/kjim.2020.470. Epub 2021 Aug 20.
BACKGROUND/AIMS: Hypoxemia in chronic obstructive pulmonary disease (COPD) leads to reduced ability to exercise, decreased quality of life, and, eventually, increased mortality. Home oxygen therapy in patients with severe COPD reduces distress symptoms and mortality rates. However, there have been few studies on physicians' prescription behavior toward home oxygen therapy. Therefore, we investigated the respiratory specialists' perspective on home oxygen therapy.
In this cross-sectional, study, a questionnaire was completed by 30 pulmonary specialists who worked in tertiary hospitals and prescribed home oxygen therapy. The questionnaire consisted of 28 items, including 15 items on oxygen prescription for outpatients, four for inpatients, and nine on service improvement.
All physicians were prescribing less than 2 L/min of oxygen for either 24 (n = 10, 33.3%) or 15 hours (n = 9, 30.3%). All (n = 30) used pulse oximetry, 26 (86.7%) analyzed arterial blood gas. Thirteen physicians had imposed restrictions and recommended oxygen use only during exercise or sleep. Sixteen (53.3%) physicians were educating their patients about home oxygen therapy. Furthermore, physicians prescribed home oxygen to patients that did not fit the typical criteria for long-term oxygen therapy, with 30 prescribing it for acute relief and 17 for patients with borderline hypoxemia.
This study identified the prescription pattern of home oxygen therapy in Korea. Respiratory physicians prescribe home oxygen therapy to hypoxemic COPD patients for at least 15 hours/day, and at a rate of less than 2 L/min. More research is needed to provide evidence for establishing policies on oxygen therapy in COPD patients.
背景/目的：慢性阻塞性肺疾病（COPD）患者的低氧血症会导致运动能力下降、生活质量降低，最终导致死亡率增加。严重 COPD 患者的家庭氧疗可减轻痛苦症状和死亡率。然而，关于医生对家庭氧疗的处方行为的研究较少。因此，我们调查了呼吸科专家对家庭氧疗的看法。
在这项横断面研究中，30 名在三级医院工作并开具家庭氧疗处方的肺病专家完成了一份问卷。问卷包括 28 个项目，其中 15 个是关于门诊患者的氧气处方，4 个是关于住院患者的氧气处方，9 个是关于改善服务的。
所有医生开的氧气流量都低于 2 L/min，持续时间分别为 24 小时（n = 10，33.3%）或 15 小时（n = 9，30.3%）。所有医生（n = 30）都使用脉搏血氧仪，26 名（86.7%）分析动脉血气。13 名医生规定并建议仅在运动或睡眠时使用氧气。16 名（53.3%）医生在教育患者家庭氧疗。此外，医生给不符合长期氧疗典型标准的患者开家庭氧疗处方，其中 30 名用于急性缓解，17 名用于有边界性低氧血症的患者。
本研究确定了韩国家庭氧疗的处方模式。呼吸科医生为低氧血症 COPD 患者开具家庭氧疗处方，至少每天 15 小时，流量低于 2 L/min。需要更多的研究为 COPD 患者的氧疗政策提供证据。
