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Characteristics at the time of oxygen initiation associated with its adherence: Findings from the COPD Long-term Oxygen Treatment Trial - 16/03/19

Doi : 10.1016/j.rmed.2019.02.004 
Marilyn L. Moy a, ⁎ , Kathleen F. Harrington b, Alice L. Sternberg c, Jerry A. Krishnan d, Richard K. Albert e, David H. Au f, Richard Casaburi g, Gerard J. Criner h, Philip Diaz i, Richard E. Kanner j, Ralph J. Panos k, Thomas Stibolt l, James K. Stoller m, James Tonascia n, Roger D. Yusen o, Ai-Yui M. Tan p, Anne L. Fuhlbrigge e

for the LOTT Research Group1

  Members of the LOTT Research Group are listed at the end of the Appendix.

a Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System and Harvard Medical School, Boston, MA, USA 
b Division of Pulmonary, Allergy and Critical Care Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA 
c Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA 
d University of Illinois at Chicago College of Medicine, Chicago, IL, USA 
e University of Colorado School of Medicine, Aurora, CO, USA 
f Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle, WA, USA 
g Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA 
h Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA 
i Pulmonary, Allergy, Critical Care, and Sleep Medicine Division, Ohio State University, Columbus, OH, USA 
j Division of Pulmonary Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, USA 
k Cincinnati Veterans Affairs Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA 
l Kaiser Permanente Center for Health Research, Portland, OR, USA 
m Cleveland Clinic, Cleveland, OH, USA 
n Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA 
o Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO, USA 
p Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA 

∗Corresponding author. VA Boston Healthcare System/Harvard Medical School, 1400 VFW Parkway, Boston, MA 02132, USA.VA Boston Healthcare System/Harvard Medical School1400 VFW ParkwayBostonMA02132USA

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.

Le texte complet de cet article est disponible en PDF.

Highlights

•
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.

Le texte complet de cet article est disponible en PDF.

Keywords : LTOT, COPD, Adherence, Self-efficacy, Readiness, Confidence


Plan


☆ This paper is subject to the NIH Public Access Policy. The LOTT is registered at clinicaltrials.gov (NCT00692198).


© 2019  Elsevier Ltd. Tous droits réservés.
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Vol 149

P. 52-58 - mars 2019 Retour au numéro
Article précédent Article précédent
  • Effect of a mHealth intervention on adherence in adolescents with asthma: A randomized controlled trial
  • Richelle C. Kosse, Marcel L. Bouvy, Tjalling W. de Vries, Ellen S. Koster

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