The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
The Johns Hopkins University, Baltimore, MD, USA.
BMC Pulm Med. 2024 Oct 8;24(1):491. doi: 10.1186/s12890-024-03248-7.
Long term oxygen therapy (LTOT) is prescribed for hypoxemia in pulmonary disease. Like other medical therapies, LTOT requires a prescription documenting the dosage (flow rate) and directions (at rest, with activity) which goes to a supplier. Communication with patients regarding oxygen prescription (flow rate, frequency, directions), monitoring (pulse oximetry) and dosage adjustment (oxygen titration) differs in comparison with medication prescriptions. We examined the communication of oxygen management plans in the electronic health record (EHR), and their consistency with patient-reported LTOT use.
A cross-sectional study was conducted in 71 adults with chronic lung disease on LTOT. Physician communication regarding oxygen management was obtained from the EHR. Participants were interviewed on their LTOT management plan. The information from each source was compared.
The study population was, on average, 64 years, two-thirds women, and most used oxygen for over 3 years. Only 45% of both at-rest and with-activity oxygen prescriptions were documented in the Electronic Health Record (EHR). Less than 20% of prescriptions were relayed to the patient in the after-visit summary. Of those with EHR-documented oxygen prescriptions, 44% of patients adhered to prescribed oxygen flow rates. Nearly all patients used a pulse oximeter (96%).
We identified significant gaps in communication of oxygen management plans from provider to patient. Even when the oxygen prescription was clearly documented, there were differences in patient-reported oxygen management. Critical gaps in oxygen therapy result from the lack of consistent documentation of oxygen prescriptions in the EHR and patient-facing documents. Addressing these issues systematically may improve home oxygen management.
长期氧疗（LTOT）用于治疗肺部疾病引起的低氧血症。与其他医疗疗法一样，LTOT 需要开具处方，记录剂量（流速）和使用说明（休息时、活动时），并将处方交给供应商。与药物处方相比，与患者沟通氧疗处方（流速、频率、使用说明）、监测（脉搏血氧饱和度）和剂量调整（氧滴定）有所不同。我们研究了电子健康记录（EHR）中氧气管理计划的沟通情况，并将其与患者报告的 LTOT 使用情况进行了比较。
对 71 名慢性肺部疾病 LTOT 患者进行了横断面研究。从 EHR 中获取医生关于氧气管理的沟通信息。对患者进行了 LTOT 管理计划访谈。比较了每个来源的信息。
研究人群平均年龄为 64 岁，三分之二为女性，大多数患者使用氧气超过 3 年。只有 45%的静息和活动时氧气处方记录在电子健康记录（EHR）中。不到 20%的处方在就诊后总结中传达给患者。在 EHR 记录氧气处方的患者中，44%的患者遵循了规定的氧气流速。几乎所有患者都使用脉搏血氧仪（96%）。
我们发现医生向患者传达氧气管理计划存在重大差距。即使氧气处方明确记录，患者报告的氧气管理也存在差异。由于 EHR 和面向患者的文件中缺乏氧气处方的一致记录，导致氧气治疗存在严重缺陷。系统地解决这些问题可能会改善家庭氧气管理。
