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Koo, Song, Lee, Lee, Kim, Park, Jung, Choi, Lee, Hur, Lee, Yum, Choi, and Lee: Clinical Characteristics and Adherence of Patients Who Were Prescribed Home Oxygen Therapy Due to Chronic Respiratory Failure in One University Hospital: Survey after National Health Insurance Coverage
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 66(3): 192-197.

Published online: 31 March 2009

DOI: https://doi.org/10.4046/trd.2009.66.3.192

Clinical Characteristics and Adherence of Patients Who Were Prescribed Home Oxygen Therapy Due to Chronic Respiratory Failure in One University Hospital: Survey after National Health Insurance Coverage

Ho-Seok Koo, M.D.1, Young Jin Song, M.D.1, Seung Heon Lee, M.D.1, Young Min Lee, M.D.1, Hyun Gook Kim, M.D.2, I-Nae Park, M.D.3, Hoon Jung, M.D.4, Sang Bong Choi, M.D.5, Sung-Soon Lee, M.D.4, Jin-Won Hur, M.D.4, Hyuk Pyo Lee, M.D.5, Ho-Kee Yum, M.D.3, Soo Jeon Choi, M.D.5, Hyun-Kyung Lee, M.D.1

1Division of Pulmonary and Critical Care Medicine, Pusan Paik Hospital, Inje University, Busan, Korea.

2Department of Internal Medicine, Dongrae Paik Hospital, Inje University, Busan, Korea.

3Department of Internal Medicine, Seoul Paik Hospital, Inje University, Seoul, Korea.

4Division of Pulmonary and Critical Care Medicine, Ilsan Paik Hospital, Inje University, Goyang, Korea.

5Department of Internal Medicine, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea.

Address for correspondence: Hyun-Kyung Lee, M.D. Division of Pulmonary and Critical Care Medicine, Pusan Paik Hospital, College of Medicine, Inje University, 633-165, Gaegum-2-dong, Jin-gu, Busan 614-735, Korea. Phone: 82-51-890-6847, Fax: 82-51-892-0273, goodoc@gmail.com

Received 5 January 2009       Accepted 18 February 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage.

Methods

This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy.

Results

During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8±7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4±3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7±4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7).

Conclusion

The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.

Keywords: Chronic obstructive pulmonary disease, Home oxygen therapy, Adherence

Figures and Tables

Figure 1
The cause of stopping oxygen (n=66, 62.8%).
trd-66-192-g001
Figure 2
The causes of voluntary stop (n=24).
trd-66-192-g002
Table 1
Underlying diseases of patients prescribed home oxygen therapy
trd-66-192-i001

COPD: chronic obstructive pulmonary disease.

Table 2
Changes of subjective symptoms after home oxygen therapy
trd-66-192-i002

The number in parenthesis means percentage (%).

Table 3
Comparison between O2 maintenance group vs. voluntary stop group
trd-66-192-i003

EF: ejection fraction; RVSP: right ventricular systolic pressure.

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