A critical look at the use of supplemental oxygen, questioning its necessity and impact on patients' quality of life.
Professor, Department of Medicine, Uniformed Services University, Bethesda, Maryland; Physician, Pulmonary/Sleep and Critical Care Medicine, MedStar Washington Hospital Center, Washington, DC Serve(d) as a director, office, partner, employee, advisor, consultant, or trustee for: Metapharm Inc. Dr Magnus Ekström started with quite the understatement: “The fact that we all need oxygen to survive might make the benefit of supplemental oxygen in hypoxemia seem obvious. It is not.
” at a cost of $2 billion annually, and that’s just the financial burden. Don’t forget the countless mind-numbing work hours devoted to durable medical equipment coordination. While the impact of oxygen on my patients’ quality of life (QOL) is unclear, I know precisely how it affects mine.compared 15 vs 24 hours per day of supplemental oxygen in patients with resting hypoxemia. All of these trials were negative. As such, the indications for oxygen are worthy of review., in the early 1980s. Researchers made patient calls using rotatory land lines and tabulated data on their Commodore 64s. No doubt theyIs it time to move on? Of course not. Despite my sarcasm, these nearly 45-year-old RCTs have aged quite well. , the authors state the obvious: Many patients despise oxygen. It’s viewed as a burden, a “ball and chain.” While most (including me) still believe that there’s a mortality benefit, the major RCTs that inform what we know show little effect on anything else — measured QOL, exercise tolerance, and respiratory symptoms didn’t change. TheThe REDOX editorial suggests we address payment structures so that “the oxygen-delivery system provided to a patient is determined according to medical necessity and not by financial considerations.” This is great and I hope In the interest of cost-efficiency, though, it’s on the prescribers to tailor our orders to our patients, not their oxygen saturation. This means having a sober discussion about what oxygen will do for the
Supplemental Oxygen Hypoxemia Medical Necessity Cost-Efficiency Patient Care
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