Observance à l'oxygénothérapie gazeuse de déambulation. Évaluation et déterminants chez des patients bénéficiant d'une oxygénothérapie de longue durée

Background.- The provision of ambulatory oxygen in addition to a stationary oxygen supply has been suggested to increase adherence to long-term oxygen therapy (LTOT) and promote ambulation. The degree of adherence to ambulatory oxygen therapy and the determinants of adherence remain largely unknown. Methods.- These were assessed in patients treated with LTOT (oxygen concentrator plus small oxygen cylinders with a demand oxygen delivery system [DODS]) in a tertiary care hospital supplied according to the Belgian criteria for LTOT refunding. Adherence to ambulatory oxygen was defined as mean use of ambulatory oxygen greater than 30 min/day. Patients- files were reviewed and a questionnaire was sent for assessing patients- view on the use of ambulatory oxygen. Results.- Forty-six patients were included. Mean use of ambulatory oxygen was 40±36 min/day. Twenty-three patients were adherent to ambulatory oxygen according to our definition. There was no difference between adherent and non-adherent patients regarding lung function or blood gases, nor was there any correlation between mean daily ambulatory oxygen use and any parameter. However, patients with MMRC 4 dyspnoea scale had a significantly lower use of ambulatory oxygen than patients with less severe dyspnoea (mean 33±24 vs 42±39 min/day ; P = 0.03) despite self reporting better adherence to LTOT. Conclusion.- Adherence to ambulatory oxygen in this series of patients is quite low but at the higher end of data reported previously. Patients with MMRC 4 dyspnoea scale had a lower use of ambulatory oxygen despite reporting better adherence to LTOT. We could not identify any other predictive factors of adherence to ambulatory oxygen.