Marilyn L Moy1, Kathleen F Harrington2, Alice L Sternberg3, Jerry A Krishnan4, Richard K Albert5, David H Au6, Richard Casaburi7, Gerard J Criner8, Philip Diaz9, Richard E Kanner10, Ralph J Panos11, Thomas Stibolt12, James K Stoller13, James Tonascia14, Roger D Yusen15, Ai-Yui M Tan16, Anne L Fuhlbrigge5. 1. Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System and Harvard Medical School, Boston, MA, USA. Electronic address: marilyn.moy@va.gov. 2. Division of Pulmonary, Allergy and Critical Care Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. 3. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. 4. University of Illinois at Chicago College of Medicine, Chicago, IL, USA. 5. University of Colorado School of Medicine, Aurora, CO, USA. 6. Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle, WA, USA. 7. Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA. 8. Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA. 9. Pulmonary, Allergy, Critical Care, and Sleep Medicine Division, Ohio State University, Columbus, OH, USA. 10. Division of Pulmonary Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, USA. 11. Cincinnati Veterans Affairs Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA. 12. Kaiser Permanente Center for Health Research, Portland, OR, USA. 13. Cleveland Clinic, Cleveland, OH, USA. 14. Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. 15. Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO, USA. 16. Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Abstract
RATIONALE: Characteristics associated with adherence to long-term oxygen therapy (LTOT) in COPD remain unclear. OBJECTIVES: To identify patient characteristics at the time of oxygen initiation associated with its adherence. METHODS: We conducted a secondary analysis of data from 359 COPD participants assigned to oxygen in the Long-term Oxygen Treatment Trial. Participants were prescribed continuous (n = 214) or intermittent (n = 145) oxygen based on desaturation patterns at study entry. At the time of initial prescription, participants rated their perceived readiness, confidence, and importance to use oxygen on a 0-10 scale (0 = not at all, 10 = very much). During follow-up, they self-reported average hours per day of use (adherence). Adherence was averaged over short-term (0-30 days), medium-term (months 9-12), and long-term (month 13 to last follow-up) intervals. Multivariable logistic regression models explored characteristics associated with high adherence (≥16 h/day [continuous] or ≥8 h/day [intermittent]) during each time interval. RESULTS:Participant readiness, confidence, and importance at the time of oxygen initiation were associated with high short- and medium-term adherence. For each unit increase in baseline readiness, the odds of high short-term adherence increased by 21% (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.05-1.40) and 94% (OR 1.94, 95% CI 1.45-2.59) in the continuous and intermittent groups, respectively. In both groups, high adherence in the medium-term was associated with high adherence in the long-term (continuous, OR 12.49, 95% CI 4.90-31.79; intermittent, OR 38.08, 95% CI 6.96-208.20). CONCLUSIONS:Readiness, confidence, and importance to use LTOT at initiation, and early high adherence, are significantly associated with long-term oxygen adherence.
RCT Entities:
RATIONALE: Characteristics associated with adherence to long-term oxygen therapy (LTOT) in COPD remain unclear. OBJECTIVES: To identify patient characteristics at the time of oxygen initiation associated with its adherence. METHODS: We conducted a secondary analysis of data from 359 COPDparticipants assigned to oxygen in the Long-term Oxygen Treatment Trial. Participants were prescribed continuous (n = 214) or intermittent (n = 145) oxygen based on desaturation patterns at study entry. At the time of initial prescription, participants rated their perceived readiness, confidence, and importance to use oxygen on a 0-10 scale (0 = not at all, 10 = very much). During follow-up, they self-reported average hours per day of use (adherence). Adherence was averaged over short-term (0-30 days), medium-term (months 9-12), and long-term (month 13 to last follow-up) intervals. Multivariable logistic regression models explored characteristics associated with high adherence (≥16 h/day [continuous] or ≥8 h/day [intermittent]) during each time interval. RESULTS:Participant readiness, confidence, and importance at the time of oxygen initiation were associated with high short- and medium-term adherence. For each unit increase in baseline readiness, the odds of high short-term adherence increased by 21% (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.05-1.40) and 94% (OR 1.94, 95% CI 1.45-2.59) in the continuous and intermittent groups, respectively. In both groups, high adherence in the medium-term was associated with high adherence in the long-term (continuous, OR 12.49, 95% CI 4.90-31.79; intermittent, OR 38.08, 95% CI 6.96-208.20). CONCLUSIONS: Readiness, confidence, and importance to use LTOT at initiation, and early high adherence, are significantly associated with long-term oxygen adherence.
Authors: Richard Casaburi; Janos Porszasz; Ariel Hecht; Brian Tiep; Richard K Albert; Nicholas R Anthonisen; William C Bailey; John E Connett; J Allen Cooper; Gerard J Criner; Jeffrey Curtis; Mark Dransfield; Stephen C Lazarus; Barry Make; Fernando J Martinez; Charlene McEvoy; Dennis E Niewoehner; John J Reilly; Paul Scanlon; Steven M Scharf; Frank C Sciurba; Prescott Woodruff Journal: COPD Date: 2012-02 Impact factor: 2.409
Authors: Susan S Jacobs; Kathleen O Lindell; Eileen G Collins; Chris M Garvey; Carme Hernandez; Sally McLaughlin; Ann M Schneidman; Paula M Meek Journal: Ann Am Thorac Soc Date: 2018-01
Authors: Richard K Albert; David H Au; Amanda L Blackford; Richard Casaburi; J Allen Cooper; Gerard J Criner; Philip Diaz; Anne L Fuhlbrigge; Steven E Gay; Richard E Kanner; Neil MacIntyre; Fernando J Martinez; Ralph J Panos; Steven Piantadosi; Frank Sciurba; David Shade; Thomas Stibolt; James K Stoller; Robert Wise; Roger D Yusen; James Tonascia; Alice L Sternberg; William Bailey Journal: N Engl J Med Date: 2016-10-27 Impact factor: 91.245