Perfiles de movilidad de los pacientes con oxigenoterapia crónica domiciliaria

A telephone-based survey of current trends, habits and beliefs in patients receiving portable oxygen therapy in Madrid, Spain

Portable oxygen therapy is a major challenge for patients and clinicians. Additionally, the available evidence on this subject is poor considering that only a few studies have been published and the results have not been encouraging. We explored the current trends, habits and beliefs among patients receiving portable oxygen therapy in a geographical area of Madrid, Spain (4 051 862 inhabitants). A telephone-based survey was conducted among patients selected from a database who were undergoing portable oxygen therapy. The number of patients on home respiratory therapies on December 31, 2017 was 81 559 (prevalence 2013.30 per 100 000 inhabitants). A total of 19 492 patients were on home oxygen therapy (HOT) (prevalence 481.16 per 100 000 inhabitants). Of these, 4015 patients (20% of the total of patients on HOT) received ambulatory oxygen therapy. In the analysed period, 1942 patients were selected (57.31% male and 42.69% female). The mean±sd age was 73.89±11.67 years. Most of patients had portable oxygen concentrators (99.59%). The survey was completed by 1777 patients. Most of patients thought they had been prescribed HOT for respiratory failure. 55% of the participants surveyed reported having carried out a walking test with oxygen to know the amount of oxygen they needed. 71% of the participants reported leaving the home for between 1 and 3 h a day. Most of them were carrying portable devices in a wheeled cart (51.94%). Our study data obtained from a large sample of oxygen-dependent individuals provide valuable information regarding domiciliary and portable oxygen usage in Madrid.

Getting on with living life: experiences of older adults after home care

Providers in all settings are increasingly aware of the need to focus on transitional care needs and services across healthcare settings to improve quality of life, maintain optimal health, and prevent unnecessary hospitalizations. Home care is an essential piece of the transitional care puzzle, especially in providing services to support older adults with chronic comorbid conditions to remain at home safely with optimal health and psychosocial well-being. Home care is essential in bridging the gap from acute hospital care to home; however, little is known about the needs of older adults after discharge from home care. Our study investigated the perceptions of older adults with chronic health conditions after discharge from home care regarding their daily activities and healthcare needs and identified how these needs were met.

The debate on continuous home oxygen therapy

Two studies published in the early 80s, namely the Nocturnal Oxygen Therapy Trial (NOTT) and the Medical Research Council Trial (MRC), laid the foundations for modern home oxygen therapy. Since then, little progress has been made in terms of therapeutic indications, and several prescription-associated problems have come to light. Advances in technology have gone hand in hand with growing disregard for the recommendations in clinical guidelines on oxygen therapy. The introduction of liquid oxygen brought with it a number of technical problems, clinical problems related to selecting candidate patients for portable delivery devices, and economic problems associated with the rising cost of the therapy. Continuous home oxygen therapy has been further complicated by the recent introduction of portable oxygen concentrators and the development in quick succession of a range of delivery devices with different levels of efficiency and performance. Modern oxygen therapy demands that clinicians evaluate the level of mobility of their patients and the mobility permitted by available oxygen sources, correctly match patients with the most appropriate oxygen source and adjust the therapy accordingly. The future of continuous home oxygen therapy lies in developing the ideal delivery device, improving the regulations systems and information channels, raise patient awareness and drive research.