HOME OXYGEN-THERAPY - A COMPARISON OF 2-MONTH VS 6-MONTH PATIENT REEVALUATION

Study objective: To contrast the effectiveness of 2- vs 6-month reeval uation intervals on both clinical outcome and cost in patients requiri ng continuous home oxygen therapy (HOT). Design: Prospective, randomiz ed clinical trial. Setting: The outpatient program of a university-aff iliated Veterans Affairs Medical Center (VAMC) Pulmonary Service. Pati ents: Fifty patients were chosen from among a cohort of 200 patients c urrently enrolled in our HOT program. All met specific arterial blood gas criteria, were able to give informed consent, had at least 6 month s of prior HOT usage, and did not have any illness expected to indepen dently shorten life expectancy. Interventions: Baseline resting oxygen now rates were prescribed based on the results of arterial blood gas measurements so as to attain a PaO2 > 60 mm Hg. Flow rates were adjust ed as needed during a 12-min walk to maintain pulse oximetry readings > 90%. No adjustments in baseline flow rates were made during sleep, I dentical evaluations were repeated at either 2- or B-month intervals. Measurements and results: At 1-year follow-up, there were no significa nt differences between the 2- and B-month groups in any of the clinica l outcome parameters measured, ie, number of emergency department visi ts, number of hospitalizations, number of days hospitalized, or mortal ity. Total costs were not significantly different between the two grou ps. Evaluation costs were less in the 6-month follow-up group. Conclus ions: After attaining stability following at least 6 months of continu ous HOT usage, patients receiving continuous HOT need not be routinely reevaluated more frequently than every 6 months.