Oxygen therapy for interstitial lung disease: physicians' perceptions and experiences

Abstract

RATIONALE: Domiciliary oxygen therapy (DOT) is commonly prescribed for patients with interstitial lung disease (ILD) and hypoxaemia, although evidence supporting benefit is limited. OBJECTIVES: The aim of this study was to explore perspectives of respiratory physicians about DOT in patients with ILD. METHODS: A qualitative study was undertaken with 26 respiratory physicians from Australia. Interviews were transcribed verbatim and coded independently by two investigators. Themes were established by consensus. RESULTS: Physicians reported symptomatic relief as the main indication for prescribing DOT in ILD. Concerns were raised regarding the applicability of current clinical guidelines for DOT to ILD. Compared to patients with other lung diseases, there was a lower threshold for DOT prescription for patients with ILD. Physicians perceived patients with ILD complied better with recommended DOT prescription. There was significant variation in infrastructure for oxygen assessment and prescription, patient support and equipment provision amongst institutions and states. Various patients' attitudes and experiences towards DOT were reported, but notable was physicians' perception of significant anxiety in most patients using DOT due to social stigma and concerns that DOT signified end-stage disease. CONCLUSIONS: Oxygen therapy was primarily prescribed for symptomatic management in patients with ILD. Education provision and supports regarding DOT varied significantly.