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Ambulatory oxygen: why do COPD patients not use their portable systems as prescribed? A qualitative study

Ambulatory oxygen: why do COPD patients not use their portable systems as prescribed? A qualitative study
Ambulatory oxygen: why do COPD patients not use their portable systems as prescribed? A qualitative study
Background: patients with COPD on long term oxygen therapy frequently do not adhere to their prescription, and they frequently do not use their ambulatory oxygen systems as intended. Reasons for this lack of adherence are not known. The aim of this study was to obtain in-depth information about perceptions and use of prescribed ambulatory oxygen systems from patients with COPD to inform ambulatory oxygen design, prescription and management.

Methods: a qualitative design was used, involving semi-structured face-to-face interviews informed by a grounded theory approach. Twenty-seven UK community-dwelling COPD patients using NHS prescribed ambulatory systems were recruited. Ambulatory oxygen systems comprised cylinders weighing 3.4 kg, a shoulder bag and nasal cannulae.

Results: participants reported that they: received no instruction on how to use ambulatory oxygen; were uncertain of the benefits; were afraid the system would run out while they were using it (due to lack of confidence in the cylinder gauge); were embarrassed at being seen with the system in public; and were unable to carry the system because of the cylinder weight. The essential role of carers was also highlighted, as participants with no immediate carers did not use ambulatory oxygen outside the house.

Conclusions: these participants highlighted previously unreported problems that prevented them from using ambulatory oxygen as prescribed. Our novel findings point to: concerns with the lack of specific information provision; the perceived unreliability of the oxygen system; important carer issues surrounding managing and using ambulatory oxygen equipment. All of these issues, as well as previously reported problems with system weight and patient embarrassment, should be addressed to improve adherence to ambulatory oxygen prescription and enhance the physical and social benefits of maintaining mobility in this patient group. Increased user involvement in both system development and service provision planning, could have avoided many of the difficulties highlighted by this study
1471-2466
1-9
Arnold, Elizabeth
fbbd648a-07f3-48ba-9677-ddc0450e338f
Bruton, Anne
9f8b6076-6558-4d99-b7c8-72b03796ed95
Donovan-Hall, Maggie
5f138055-2162-4982-846c-5c92411055e0
Fenwick, Angela
95a1f4fa-7f6f-4c07-a93b-9ea39c231c31
Dibb, Bridget
1cdc4ce1-7f8e-4c21-80ed-c3a48cdae209
Walker, Elizabeth
6a1c1b5b-b490-47ec-8b86-7617e9503864
Arnold, Elizabeth
fbbd648a-07f3-48ba-9677-ddc0450e338f
Bruton, Anne
9f8b6076-6558-4d99-b7c8-72b03796ed95
Donovan-Hall, Maggie
5f138055-2162-4982-846c-5c92411055e0
Fenwick, Angela
95a1f4fa-7f6f-4c07-a93b-9ea39c231c31
Dibb, Bridget
1cdc4ce1-7f8e-4c21-80ed-c3a48cdae209
Walker, Elizabeth
6a1c1b5b-b490-47ec-8b86-7617e9503864

Arnold, Elizabeth, Bruton, Anne, Donovan-Hall, Maggie, Fenwick, Angela, Dibb, Bridget and Walker, Elizabeth (2011) Ambulatory oxygen: why do COPD patients not use their portable systems as prescribed? A qualitative study. BMC Pulmonary Medicine, 11 (9), 1-9. (doi:10.1186/1471-2466-11-9).

Record type: Article

Abstract

Background: patients with COPD on long term oxygen therapy frequently do not adhere to their prescription, and they frequently do not use their ambulatory oxygen systems as intended. Reasons for this lack of adherence are not known. The aim of this study was to obtain in-depth information about perceptions and use of prescribed ambulatory oxygen systems from patients with COPD to inform ambulatory oxygen design, prescription and management.

Methods: a qualitative design was used, involving semi-structured face-to-face interviews informed by a grounded theory approach. Twenty-seven UK community-dwelling COPD patients using NHS prescribed ambulatory systems were recruited. Ambulatory oxygen systems comprised cylinders weighing 3.4 kg, a shoulder bag and nasal cannulae.

Results: participants reported that they: received no instruction on how to use ambulatory oxygen; were uncertain of the benefits; were afraid the system would run out while they were using it (due to lack of confidence in the cylinder gauge); were embarrassed at being seen with the system in public; and were unable to carry the system because of the cylinder weight. The essential role of carers was also highlighted, as participants with no immediate carers did not use ambulatory oxygen outside the house.

Conclusions: these participants highlighted previously unreported problems that prevented them from using ambulatory oxygen as prescribed. Our novel findings point to: concerns with the lack of specific information provision; the perceived unreliability of the oxygen system; important carer issues surrounding managing and using ambulatory oxygen equipment. All of these issues, as well as previously reported problems with system weight and patient embarrassment, should be addressed to improve adherence to ambulatory oxygen prescription and enhance the physical and social benefits of maintaining mobility in this patient group. Increased user involvement in both system development and service provision planning, could have avoided many of the difficulties highlighted by this study

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Published date: 2011
Organisations: Medical Education, Health Sciences

Identifiers

Local EPrints ID: 176539
URI: https://eprints.soton.ac.uk/id/eprint/176539
ISSN: 1471-2466
PURE UUID: da428ac4-6fb9-4c9c-87c4-3b501d85d5f7
ORCID for Anne Bruton: ORCID iD orcid.org/0000-0002-4550-2536

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Date deposited: 09 Mar 2011 08:38
Last modified: 06 Jun 2018 13:04

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