Kampelmacher M J, van Kestern R G, Alsbach G P, Melissant C F, Wynne H J, Douze J M, Lammers J W
Centre for Home Mechanical Ventilation, University Hospital Utrecht, The Netherlands.
Respir Med. 1998 Jan;92(1):70-5. doi: 10.1016/s0954-6111(98)90035-x.
In patients prescribed long-term oxygen therapy (LTOT), compliance is often poor. Both patient- and treatment-related factors seem to be involved. As a base for improvements in LTOT, the characteristics and complaints of LTOT patients were investigated. A survey was set up in a random sample of clients of the largest oxygen company in the Netherlands. Patients were selected if they were > or = 18 years old, had a phone and if they had had oxygen equipment for > or = 6 months. All patients were visited at home by a medical student. Data are presented for a total of 528 patients (response rate 62%). The typical LTOT patient was a 70-year-old male with chronic obstructive pulmonary disease (COPD), who had had oxygen equipment for 3.5 years and who used oxygen cylinders and nasal cannulae for 13 h day-1. Twenty percent of the patients still smoked. Although LTOT was prescribed in 80% of the patients by a chest physician, prescription was often inadequate. Only 33% of the patients were informed adequately about the therapy. Twenty percent of the patients used oxygen for fewer hours per day than prescribed. Non-compliant patients were mainly men (P = 0.006) and more often ashamed of their therapy (P = 0.023) than compliant patients. The blood oxygen level was monitored regularly in 73% of the patients. Most complaints concerned the oxygen equipment, especially the concentrator. The single most important complaint had to do with restricted autonomy. Only 19% of the patients had no complaints at all. It is concluded that LTOT should be improved with regard to the education, motivation and monitoring of patients. The prescribing physician needs to be included in an education programme. Given the numerous problems these patients experience, LTOT should be improved in particular with regard to equipment convenience.
在接受长期氧疗(LTOT)的患者中,依从性通常较差。患者相关因素和治疗相关因素似乎都有影响。为了改善LTOT,对LTOT患者的特征和主诉进行了调查。在荷兰最大的氧气公司的客户中随机抽取样本进行调查。入选患者年龄≥18岁,有电话,且使用氧气设备≥6个月。所有患者均由一名医学生上门访视。共呈现了528例患者的数据(应答率62%)。典型的LTOT患者是一名70岁男性,患有慢性阻塞性肺疾病(COPD),使用氧气设备3.5年,每天使用氧气瓶和鼻导管吸氧13小时。20%的患者仍在吸烟。尽管80%的患者由胸科医生开具了LTOT处方,但处方往往不充分。只有33%的患者得到了关于该治疗的充分告知。20%的患者每天吸氧时间少于规定时间。不依从的患者主要是男性(P = 0.006),与依从的患者相比,他们更常为自己的治疗感到羞耻(P = 0.023)。73%的患者定期监测血氧水平。大多数主诉与氧气设备有关,尤其是制氧机。最主要的主诉是自主性受限。只有19%的患者完全没有主诉。结论是,LTOT应在患者教育、激励和监测方面加以改进。开具处方的医生需要纳入教育计划。鉴于这些患者面临众多问题,LTOT尤其应在设备便利性方面加以改进。