Oxygen patients are worse off, report finds

NEW YORK - A new report published in the December Annals of the American Thoracic Society highlights the problems many patients with lung disease experience in getting and using supplemental oxygen.

In “Optimizing Home Oxygen Therapy: An Official American Thoracic Society Workshop Report,” 26 physicians, nurses, RTs, patients and patient advocacy groups, oxygen suppliers, and CMS and FDA officials detail the shortcomings of the current system of providing supplemental oxygen to 1.5 million adults living in the United states.

“The panel was unanimous in its finding that delivery of home oxygen services has worsened since the onset of CMS's competitive bidding program nearly a decade ago,” a press release states.
The workshop authors reviewed available scientific oxygen studies and the results of a 2017 survey of nearly 2,000 supplemental oxygen users conducted by the ATS Nursing Assembly.

They found:

• Half of respondents reported problems with their oxygen;
• 70% of all respondents reported they had no more than four hours of portable oxygen, yet 81% reported they wanted more than five hours;
• Patients who have been hospitalized or gone to the ER in the last year were more likely to report problems; and
• Liquid oxygen is often not available in many parts of the country, especially in rural areas.

The report attributes some of the problems patients report to the “unintended consequences” of the bid program and cuts in reimbursement to DME providers. These cutbacks, the authors believe, may have contributed to increased complaints about unreliable equipment, inconvenient delivery schedules, poor communication between providers and patients, and fewer RTs to educate and test patients at home.

Among other findings:

• Many healthcare providers who prescribe oxygen lack the knowledge to prescribe the best oxygen delivery services for their patients;
• Patients with certain lung diseases and those with higher oxygen needs must have greater access to lightweight, higher flow liquid oxygen systems within the constraints of CMS reimbursement;
• Innovative approaches to patient education, such as remote monitoring and telemedicine, would likely improve the current state of absent or fragmented communication and follow up; and
• Research is also needed to better determine which patients will benefit from oxygen therapy and to devise a new generation of portable oxygen devices.