Carme Hernandez1, Jesús Aibar2, Jordi de Batlle3, David Gomez-Cabrero4, Nestor Soler2, Enric Duran-Tauleria5, Judith Garcia-Aymerich5, Xavier Altimiras6, Monica Gomez2, Alvar Agustí2, Joan Escarrabill7, David Font2, Josep Roca2. 1. Hospital Clinic de Barcelona, CIBER en Enfermedades Respiratorias (CIBERES), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Catalonia, Spain; Master Plan for Respiratory Diseases (PDMAR) and Respiratory Therapies Observatory (ObsTRD), Ministry of Health and REDISSEC (Research Network in Chronic Care), Barcelona, Catalonia, Spain. Electronic address: chernan@clinic.ub.es. 2. Hospital Clinic de Barcelona, CIBER en Enfermedades Respiratorias (CIBERES), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Catalonia, Spain. 3. International Agency for Research on Cancer (IARC), Lyon, France. 4. Unit of Computational Medicine, Department of Medicine, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Sweden. 5. Centre de Recerca en Epidemiologia Ambiental (CREAL), CIBER en Epidemiologia y Salud Pública (CIBERESP), Department of experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain. 6. Consorci Sanitari de Barcelona, Servei Català de la Salut, Generalitat de Catalunya, Spain. 7. Hospital Clinic de Barcelona, CIBER en Enfermedades Respiratorias (CIBERES), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Catalonia, Spain; Master Plan for Respiratory Diseases (PDMAR) and Respiratory Therapies Observatory (ObsTRD), Ministry of Health and REDISSEC (Research Network in Chronic Care), Barcelona, Catalonia, Spain.
Abstract
BACKGROUND: Despite well established clinical guidelines, performance of long-term oxygen therapy (LTOT) programs shows marked variability among territories. The current study assessed the LTOT program and the health status of patients on LTOT prior to the deployment of community-based integrated care in an urban health district of Barcelona (Spain). AIMS: To assess: i) the LTOT program and health status of the patients on LTOT in the health district; ii) their frailty profile; and, iii) the requirements for effective deployment of integrated care services for these patients. METHODS: Cross-sectional observational study design including all patients (n = 406) on LTOT living in the health district. Health status, frailty, arterial blood gases, forced spirometry and hand-grip muscle strength were measured. Network analysis of frailty was carried out. RESULTS: Adequacy of LTOT prescription (n = 362): 47% and 31% of the patients had PaO2 ≤ 60 mmHg and ≤55 mmHg, respectively. Adherence to LTOT: 31% of all patients used LTOT ≥15 h/d; this figure increased to 67% in those with PaO2≤60 mmHg. Assessment of frailty: Overall, LTOT patients presented moderate to severe frailty. Care complexity was observed in 42% of the patients. CONCLUSIONS: Adequacy and adherence to LTOT was poor and many patients were frail and complex. The outcomes of the network analysis may contribute to enhance assessment of frailty in LTOT patients. These observations suggest that an integrated care strategy has the potential to improve the health outcomes of these patients.
BACKGROUND: Despite well established clinical guidelines, performance of long-term oxygen therapy (LTOT) programs shows marked variability among territories. The current study assessed the LTOT program and the health status of patients on LTOT prior to the deployment of community-based integrated care in an urban health district of Barcelona (Spain). AIMS: To assess: i) the LTOT program and health status of the patients on LTOT in the health district; ii) their frailty profile; and, iii) the requirements for effective deployment of integrated care services for these patients. METHODS: Cross-sectional observational study design including all patients (n = 406) on LTOT living in the health district. Health status, frailty, arterial blood gases, forced spirometry and hand-grip muscle strength were measured. Network analysis of frailty was carried out. RESULTS: Adequacy of LTOT prescription (n = 362): 47% and 31% of the patients had PaO2 ≤ 60 mmHg and ≤55 mmHg, respectively. Adherence to LTOT: 31% of all patients used LTOT ≥15 h/d; this figure increased to 67% in those with PaO2≤60 mmHg. Assessment of frailty: Overall, LTOT patients presented moderate to severe frailty. Care complexity was observed in 42% of the patients. CONCLUSIONS: Adequacy and adherence to LTOT was poor and many patients were frail and complex. The outcomes of the network analysis may contribute to enhance assessment of frailty in LTOT patients. These observations suggest that an integrated care strategy has the potential to improve the health outcomes of these patients.
Authors: Isaac Cano; Ivan Dueñas-Espín; Carme Hernandez; Jordi de Batlle; Jaume Benavent; Juan Carlos Contel; Erik Baltaxe; Joan Escarrabill; Juan Manuel Fernández; Judith Garcia-Aymerich; Miquel Àngel Mas; Felip Miralles; Montserrat Moharra; Jordi Piera; Tomas Salas; Sebastià Santaeugènia; Nestor Soler; Gerard Torres; Eloisa Vargiu; Emili Vela; Josep Roca Journal: NPJ Prim Care Respir Med Date: 2017-07-14 Impact factor: 2.871
Authors: Erik Baltaxe; Cristina Embid; Eva Aumatell; María Martínez; Anael Barberan-Garcia; John Kelly; John Eaglesham; Carmen Herranz; Eloisa Vargiu; Josep Maria Montserrat; Josep Roca; Isaac Cano Journal: JMIR Mhealth Uhealth Date: 2020-04-13 Impact factor: 4.773