Three Years Retrospective Cohort Service Review on Home Oxygen Therapy Follow Up in Occupational Therapy Department of Kowloon Hospital

Abstract Description

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Authors (including presenting author) :

Wong HY(1), Ko WN (1), Tsui TS (1), Lee YT (1), Lau WL (1), Chan HL (1), Ng HP (1), Mok YW (2), Ling SO (2), Kwan HY (2), Yim CW (2), Poon YN (2), Yau PY (2), Ma O (2), Ng PK (2)

Affiliation :

(1) Occupational Therapy Department, Kowloon Hospital, (2) Respiratory Medicine Department, Kowloon Hospital

Introduction :

According to Clinical Practice Guideline, Home Oxygen Therapy(HOT) refers to the setting up of an oxygen system for a patient to be used at home or in residential institution, upon the initiation by a Medical Doctor for continuation of treatment of hypoxia. This review intends to describe the challenges that both patients and therapists encountered in monitoring HOT in the 1st 120 days after discharge from the hospital and to explore areas for improvement.

Objectives :

To describe the challenges that both patients and therapists encountered in monitoring HOT in the 1st 120 days after discharge from the hospital and to explore areas for improvement

Methodology :

This is a retrospective cohort recruiting patients discharged from respiratory wards from 2014 to 2017, who were recommended to use HOT upon their discharge. All of them were scheduled to be followed up (FU) either at our out-patient clinic or by our community teams within the 1st 120 days of their discharge. In addition to problems related to HOT usage, their survival was investigated.

Result & Outcome :

A total of 301 patients were recruited (73.8% being male, and, average age=77.5). The top 2 diagnostic groups were COPD (n=199 or 66.1%) and Bronchiectasis (n=30 or 10%). Short Term Oxygen Therapy (STOT) was the highest regime being recommended at the time of discharge (n=280 or 93%), which implied that either the medical conditions of the patients were not ready for certification with Arterial Blood Gases (ABG) results or the patients had reservation for long term compliance to HOT. Related to the FU, 23 patients showed improvement and had their HOT off, 4 patients remained using the regime as recommended at the time of discharge, 150 patients changed from STOT to LTOT, 2 patients changed to palliative use, 36 patients were found death, and, 79 patients defaulted the follow up appointment. The average survival time for those death cases was 54.7 (sd = 38.4) days. Of those who can be followed-up, around 33% of them did not bring portable oxygen device for outdoor activities, due to the following concerns: financial subsidy, heavy weight of the portable oxygen devices, worries about safety,etc. To conclude, there were a lot of issues contributing to HOT compliance and outcomes identified, including: communication between therapists and medical doctors for ABG lab test for home oxygen regime recertification, financial support, patients’ values, etc. A post-discharge follow-up program by OT was indicated.