Problems With Home Oxygen: Patient Perceptions

What Are Challenges Of Home Oxygen?

Background: More than one million Americans use home oxygen for a variety of lung conditions. Some of the challenges of living with oxygen include equipment, services, reimbursements, and portable systems. Many patients report that their current portable oxygen options limit them to a “stay-at-home” lifestyle. Study: The nursing assembly of the American Thoracic Society conducted a web-based survey of adults who were prescribed oxygen because of their lung disease. The survey included 60 items with a combination of multiple choice, ratings by numbers, and open-ended responses. The American Thoracic Society website posted the survey link between September 1, 2016, through October 24, 2016. Then, multiple pulmonary organizations placed the link on their websites. The study results were published in the January 2018 issue of the journal Annals of the American Thoracic Society (volume 15; pages 24-32) Results: A total of 1,926 individuals completed the survey. Most respondents used oxygen 24 hours per day for 1 – 5 years. 31% used oxygen only with activities. 39% had COPD. Sources of instruction about how to use the oxygen system included the delivery person (64%), the health care professionals (8%), and “no instruction” (10%). About 1/3 indicated that they felt “very” or “somewhat” unprepared to use or operate their equipment.
problems with home oxygen use

Frequency of types of problems with oxygen systems

51% answered that they experienced problems with the oxygen system. The most frequent were equipment malfunction, the portable oxygen system was difficult to manage, and lack of portable systems with high flow rates. When asked what “one thing” they would change to improve their oxygen experience, the most frequent answer was “more portable tanks/supplies so that I can leave home more frequently.” The next most common wish was “provide a portable oxygen concentrator (POC) when I travel.” Conclusions: The authors concluded that the most common problems for oxygen users were lack of effective instruction on how to use the oxygen system and inadequate portable systems. My Comments:  Those individuals who require oxygen 24/7 are provided with a stationary concentrator and a portable system, usually a tank, to use with activities. The size of the tank provided by the company depends a lot on the required oxygen flow rate. Obviously, the bigger the tank, the longer it will last.
Different sizes of tanks for home oxygen use

Different sizes of oxygen tanks

An E tank is commonly provided if the person needs a high flow rate such as 3 – 5 liters/min with activities. The following table shows how long a tank will last at specific flow rates. This tells you how long you
Different size tanks for home oxygen use

Table shows low long an E tank will last at specific flow rates and pressures

can be away from home before the tank runs out of oxygen, or when to switch to a new tank. For example, if the E tank if fully pressurized (2,000 psi), the tank will run out of oxygen in 4 hours at a flow rate of 2 liters/minute. Many people find that pushing or pulling an E tank on wheels can be awkward and challenging.
Woman using a portable oxygen concentrator

Woman using portable oxygen concentrator

Many patients have told me that they prefer a POC as long as the required flow rate is not too high. Here is one example of a POC. If you are not satisfied with the oxygen system that you have, make sure to mention this to your health care professional. You should also speak to a person at the company who provides the oxygen. Hopefully, someone will be able to assist you to find the best system for your specific needs.

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.