Characteristics at the time of oxygen initiation associated with its adherence: Findings from the COPD Long-term Oxygen Treatment Trial

• Published in: Respiratory medicine Vol. 149; pp. 52 - 58
• Main Authors: Moy, Marilyn L., Harrington, Kathleen F., Sternberg, Alice L., Krishnan, Jerry A., Albert, Richard K., Au, David H., Casaburi, Richard, Criner, Gerard J., Diaz, Philip, Kanner, Richard E., Panos, Ralph J., Stibolt, Thomas, Stoller, James K., Tonascia, James, Yusen, Roger D., Tan, Ai-Yui M., Fuhlbrigge, Anne L.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.03.2019; Elsevier Limited
• Subjects: Adherence; Adhesion; Aftercare; Aged; Arthritis; Chronic obstructive pulmonary disease; Clinical trials; Confidence; Confidence intervals; COPD; Data processing; Desaturation; Disease management; Disease Progression; Early Intervention, Educational - methods; Female; Hemoglobin; Humans; Hypoxia - therapy; LTOT; Male; Middle Aged; Outcome Assessment, Health Care; Oxygen; Oxygen Inhalation Therapy - psychology; Oxygen Inhalation Therapy - statistics & numerical data; Oxygen Inhalation Therapy - trends; Oxygen therapy; Patient compliance; Perception - physiology; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; Readiness; Regression analysis; Secondary analysis; Self Concept; Self Efficacy; Sleep; Statistical analysis; Time; Treatment Adherence and Compliance - psychology; Treatment Adherence and Compliance - statistics & numerical data; United States > US; Adherence; Readiness; Confidence; LTOT; Self-efficacy; COPD
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2019.02.004

Characteristics associated with adherence to long-term oxygen therapy (LTOT) in COPD remain unclear. To identify patient characteristics at the time of oxygen initiation associated with its adherence. 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. 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). Readiness, confidence, and importance to use LTOT at initiation, and early high adherence, are significantly associated with long-term oxygen adherence. •Readiness, confidence, and importance to use LTOT are associated with adherence.•Early oxygen adherence predicts later adherence.•Characteristics associated with high adherence differ initally and over time.•Adherence characteristics differ in continuous versus intermittent oxygen groups.