Patro Mahismita, Gothi Dipti, Anand Shweta, Agarwal Mohit
Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India.
Lung India. 2022 Mar-Apr;39(2):129-138. doi: 10.4103/lungindia.lungindia_445_21.
The international data shows that long-term oxygen therapy (LTOT) compliance is insufficient and variable. We conducted the first study from India on LTOT compliance, factors affecting compliance, indications, and survival through oxygen concentrator.
Our organization from Delhi had given 378 oxygen concentrators over the last 5 years. We evaluated 120 patients randomly for participating in the study. Compliance was defined as the use of LTOT for at least 15 h/day.
Ninety-seven patients were included in the final analysis after exclusion criteria. The compliance to LTOT was seen in 45.36% (44/97). The commonest cause of noncompliance was lack of instructions (49.06%) followed by electricity issues, social stigma, and workplace constraints. A higher PaCO was associated with significantly lower compliance (PaCO 53.18 vs. 44.98 mmHg, P = 0.036). Interstitial lung disease was associated with significantly higher compliance. Oxygen prescription was titrated with arterial blood gas analysis in only 4.12%. The indications for LTOT were chronic obstructive pulmonary disease (49.48%), posttuberculous obstructive airway disease (20.6%), and interstitial lung disease (12.37%). We found a significant reduction in the mean number of exacerbations/year from 3.91 to 1.93 (P < 0.0001). 61.86% of the patients were surviving on LTOT with a median survival time of 12 months.
The adherence to LTOT in Indian patients is suboptimal mainly due to lack of instruction and is associated with a higher PaCO. The practice of titration needs to be followed. The development of a national registry to monitor LTOT should be the long-term target.
国际数据显示，长期氧疗（LTOT）的依从性不足且存在差异。我们开展了印度第一项关于LTOT依从性、影响依从性的因素、适应证以及通过制氧机生存情况的研究。
我们位于德里的机构在过去5年中提供了378台制氧机。我们随机评估了120名参与研究的患者。依从性定义为每天使用LTOT至少15小时。
排除标准后，97名患者纳入最终分析。LTOT的依从率为45.36%（44/97）。最常见的不依从原因是缺乏指导（49.06%），其次是电力问题、社会耻辱感和工作场所限制。较高的动脉血二氧化碳分压（PaCO）与显著较低的依从性相关（PaCO 53.18 vs. 44.98 mmHg，P = 0.036）。间质性肺疾病与显著较高的依从性相关。仅4.12%的患者通过动脉血气分析调整氧疗处方。LTOT的适应证为慢性阻塞性肺疾病（49.48%）、结核后阻塞性气道疾病（20.6%）和间质性肺疾病（12.37%）。我们发现每年平均急性加重次数从3.91显著减少至1.93（P < 0.0001）。61.86%的患者依靠LTOT存活，中位生存时间为12个月。
印度患者对LTOT的依从性欠佳，主要原因是缺乏指导，且与较高的PaCO相关。应遵循氧疗滴定的做法。建立国家登记系统以监测LTOT应作为长期目标。
