Skip to main content
SpringerLink
Log in

Explaining adherence to supplemental oxygen therapy

The patient’s perspective

  • Original Articles
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

OBJECTIVES: To describe and explain the patterns of adherence to supplemental oxygen in individuals with hypoxemic chronic obstructive pulmonary disease (COPD).

DESIGN: Qualitative study of a case-series of patients with COPD who use supplemental oxygen.

SETTING: Denver, Colorado.

PARTICIPANTS: Community-dwelling, English speaking individuals with hypoxemic COPD receiving long-term supplemental oxygen therapy.

MEASUREMENTS: Forced expiratory lung volume, in liters, at one second (FEV1), the St. George’s Respiratory Questionnaire, Brief Symptom Inventory, semistructured investigator-administered interviews.

RESULTS: Respondents from a demographically representative sample with moderate to severe COPD (average age, 69; average FEV1, 1.1) described 3 distinct patterns of adherence to supplemental oxygen therapy: as-needed use, part-time use, and full-time use. For many individuals, the pattern of adherence changed with time and reflected their struggle to optimally manage their health, symptoms, physical function, and social milieu. Adherence to oxygen tended to increase with time and was often associated with significant personal compromises.

CONCLUSION: Adhering to oxygen therapy is a complex and difficult task with many barriers, including the physical difficulty of using the oxygen, self-consciousness and a sense of social stigma, lack of perceived benefit, and fear of deleterious side effects from treatment. Improving adherence may involve understanding the process of adapting to oxygen use and addressing the many barriers to therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Nocturnal Oxygen Therapy Trial. Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease. Ann Intern Med. 1980;93:391–8.

    Google Scholar 

  2. Block AJ, Castle JF, Keitt AS. Chronic oxygen therapy treatment of chronic obstructive pulmonary disease at sea level. Chest. 1974;65:279–88.

    PubMed  CAS  Google Scholar 

  3. Leggett RJE, Flenley DC. Portable oxygen and exercise tolerance in patients with chronic hypoxic cor pumonale. BMJ. 1977;2:84–6.

    Article  PubMed  CAS  Google Scholar 

  4. Stewart BN, Hood CI, Block AJ. Long-term results of continuous oxygen therapy at sea-level. Chest. 1975;68:486–96.

    PubMed  CAS  Google Scholar 

  5. Vergeret J, Brambilla C, Mounier L. Portable oxygen therapy: use and benefit in hypoxaemic COPD patients on long-term oxygen therapy. Eur Respir J. 1989;2:20–5.

    PubMed  CAS  Google Scholar 

  6. Levine BE, Bigelow DB, Hamstra RD, et al. The role of long-term continuous oxygen administration in patients with chronic airway obstruction with hypoxemia. Ann Intern Med. 1967;66:503–12.

    Google Scholar 

  7. Brezinova V, Claverly PMA, Flenley DC. The effect of long-term oxygen therapy on the EEG in patients with chronic airway obstruction with hypoxemia. Bull Eur Physiopathol Respir. 1979;15:603–9.

    PubMed  CAS  Google Scholar 

  8. Krop HD, Block AJ, Cohn E. Neuropsychiatric effects of continuous oxygen therapy in chronic obstructive pulmonary disease. Chest. 1973;64:317–32.

    PubMed  CAS  Google Scholar 

  9. McSweeney AJ, Grant I, Heaton RK. Life quality of patients with chronic obstructive pulmonary disease. Arch Intern Med. 1982;142:473–8.

    Article  Google Scholar 

  10. Walshaw MJ, Lim R, Evans CC. Factors influencing the compliance of patients using oxygen concentrators for long-term home oxygen therapy. Respir Med. 1990;84:331–3.

    PubMed  CAS  Google Scholar 

  11. Phillips GD, Harrison NK, Cummin ARC. A new method for measuring compliance with long-term oxygen treatment. BMJ. 1994;308:1554–5.

    Google Scholar 

  12. Burns BH, Howell JBL. Disproportionately severe breathlessness in chronic bronchitis. Q J Med. 1969;38:277–94.

    PubMed  CAS  Google Scholar 

  13. Heimlich HJ. Oxygen delivery for ambulatory patients: how the micro-trach increases mobility. Postgrad Med. 1988;84:68–79.

    PubMed  CAS  Google Scholar 

  14. Hoffman LA, Dauber JH, Ferson PF. Patient response to transtracheal oxygen delivery. Am Rev Respir Dis. 1987;136:153–6.

    Google Scholar 

  15. Derogatis LR, Melisaratos N. The brief symptom inventory: an introductory report. Psychol Med. 1983;13:595–605.

    Article  PubMed  CAS  Google Scholar 

  16. Jones PW, Quirk FH, Baveystock CM, Littlejohns P. A self-complete measure of health status for chronic airflow limitation. The St. George’s Respiratory Questionnaire. Am Rev Respir Dis. 1992;145:1321–7.

    PubMed  CAS  Google Scholar 

  17. Barr JT, Schumacher GE, Freeman S, LeMoine M, Bakst AW, Jones PW. American translation, modification, and validation of the St. George’s Respiratory Questionnaire. [abstract]. Clin Ther. 2000;22:1121–45.

    Article  PubMed  CAS  Google Scholar 

  18. Ferrar M, Alonso J, Morera J, et al. Chronic obstructive pulmonary disease stage and health-related quality of life. Ann Intern Med. 1997;127:1072–9.

    Google Scholar 

  19. Martin RJ, Pak J, Kunselman SJ, Cherniak RM. Assessment of the AirWatch lung function monitoring system. J Allergy Clin Immunol. 1999;103:535–6.

    Article  PubMed  CAS  Google Scholar 

  20. Giacomini MK, Cook DJ. Qualitative research in health care—are the results of the study valid. JAMA. 2000;284:357–62.

    Article  PubMed  CAS  Google Scholar 

  21. Steiner JF, Earnest MA. The language of medication taking. Ann Intern Med. 2000;132:926–30.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 360 S. Garfield St., Suite 500, 80209, Denver, CO

    Mark A. Earnest MD, PhD

Authors
  1. Mark A. Earnest MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark A. Earnest MD, PhD.

Additional information

Received from the University of Colorado Health Sciences Center, Denver, Colo.

This work was supported by a grant from the Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, Colo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Earnest, M.A. Explaining adherence to supplemental oxygen therapy. J GEN INTERN MED 17, 749–755 (2002). https://doi.org/10.1046/j.1525-1497.2002.20218.x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1046/j.1525-1497.2002.20218.x

Key words

Search

Navigation