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Zainab Ahmadi, Josefin Sundh, Anna Bornefalk-Hermansson, Magnus Ekström
Long-term oxygen therapy (LTOT) ≥ 15 h/day improves survival in hypoxemic chronic obstructive pulmonary disease (COPD). LTOT 24 h/day is often recommended but may pose an unnecessary burden with no clear survival benefit compared with LTOT 15 h/day. The aim was to test the hypothesis that LTOT 24 h/day decreases all-cause, respiratory, and cardiovascular mortality compared to LTOT 15 h/day in hypoxemic COPD. This was a prospective, observational, population-based study of COPD patients starting LTOT between October 1, 2005 and June 30, 2009 in Sweden...
2016: PloS One
Julie R Gaither, Joseph L Goulet, William C Becker, Stephen Crystal, E Jennifer Edelman, Kirsha Gordon, Robert D Kerns, David Rimland, Melissa Skanderson, Amy C Justice, David A Fiellin
OBJECTIVE: Patients with substance use disorders (SUDs) prescribed long-term opioid therapy (LtOT) are at risk for overdose and mortality. Prior research has shown that receipt of LtOT in accordance with clinical practice guidelines has the potential to mitigate these outcomes. Our objective was to determine whether the presence of a SUD modifies the association between guideline-concordant care and 1-year all-cause mortality among patients receiving LtOT for pain. METHODS: Among HIV+ and HIV- patients initiating LtOT (≥90 days opioids) between 2000 and 2010 as part of the Veterans Aging Cohort Study, we used time-updated Cox regression and propensity-score matching to examine-stratified by SUD status-the association between 1-year all-cause mortality and 3 quality indicators derived from national opioid-prescribing guidelines...
September 8, 2016: Journal of Addiction Medicine
Phyllis Murphie, Nick Hex, Jo Setters, Stuart Little
UNLABELLED: "Non-delivery" home oxygen technologies that allow self-filling of ambulatory oxygen cylinders are emerging. They can offer a relatively unlimited supply of ambulatory oxygen in suitably assessed people who require long-term oxygen therapy (LTOT), providing they can use these systems safely and effectively. This allows users to be self-sufficient and facilitates longer periods of time away from home. The evolution and evidence base of this technology is reported with the experience of a national service review in Scotland (UK)...
June 2016: Breathe
Fatih Kayhan, Faik Ilik, Harun Karamanli, Ahmet Cemal Pazarli, Ayşegül Kayhan
PURPOSE: We aimed to investigate the frequency of major depression (MD) in long-term oxygen therapy (LTOT) dependent chronic obstructive pulmonary disease (COPD) patients and the effect of depression on patients' compliance with the treatment. DESIGN AND METHODS: Fifty-four consecutive patients were enrolled in the study and diagnosed as stage 4 COPD according to Global Initiative for Chronic Obstructive Lung Disease guideline. MD was diagnosed with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition/Clinical Version...
May 25, 2016: Perspectives in Psychiatric Care
Jessica S Merlin, Sarah R Young, Soraya Azari, William C Becker, Jane M Liebschutz, Jamie Pomeranz, Payel Roy, Shalini Saini, Joanna L Starrels, E Jennifer Edelman
INTRODUCTION: Given the sharp rise in opioid prescribing and heightened recognition of opioid addiction and overdose, opioid safety has become a priority. Clinical guidelines on long-term opioid therapy (LTOT) for chronic pain consistently recommend routine monitoring and screening for problematic behaviours. Yet, there is no consensus definition regarding what constitutes a problematic behaviour, and recommendations for appropriate management to inform front-line providers, researchers and policymakers are lacking...
2016: BMJ Open
Stephan Walterspacher, Johanna July, Martin Kohlhäufl, Peter Rzehak, Wolfram Windisch
BACKGROUND: Respiratory insufficiency in COPD may present as hypoxic and/or hypercapnic respiratory failure treated with long-term oxygen therapy (LTOT) and/or noninvasive ventilation (NIV) with LTOT. The Severe Respiratory Insufficiency Questionnaire (SRI) is a tool for the assessment of health-related quality of life (HRQOL) in subjects receiving NIV. However, it remains unclear whether the SRI is also capable of assessing and discriminating HRQOL in subjects receiving LTOT. METHODS: Stable subjects with COPD receiving LTOT or NIV + LTOT (NIV) were prospectively recruited and completed the SRI, lung function tests, and blood gases...
September 2016: Respiratory Care
Michele Vitacca, Mara Paneroni, Francesco Grossetti, Nicolino Ambrosino
UNLABELLED: The evidence for tele-assistance (TA) in hypercapnic chronic obstructive pulmonary disease (COPD) patients on long-term oxygen therapy (LTOT) is scarce. The aim of this study was to evaluate the effects of addition of long-term TA to LTOT with or without non-invasive ventilation (NIV) in these patients. Retrospective analysis of a previous randomised study of patients on LTOT. According to the care programme patients were divided into Group 1: LTOT; Group 2: LTOT + NIV; Group 3: LTOT + TA and Group 4: LTOT + NIV+TA...
October 2016: COPD
Magnus Ekström, Anna Bornefalk-Hermansson
BACKGROUND AND OBJECTIVE: Severe idiopathic pulmonary fibrosis is associated with an increased risk of cardiovascular disease and gastro-oesophageal reflux, which may influence prognosis. We evaluated associations between cardiovascular and antacid medications, and mortality, in oxygen-dependent pulmonary fibrosis (PF) of unknown cause. METHODS: Prospective population-based study of adults starting long-term oxygen therapy (LTOT) for PF in Sweden 2005-2009. PF of unknown cause was defined by excluding patients with known or probable secondary PF...
May 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Winfried Häuser, Frank Petzke, Lukas Radbruch, Thomas R Tölle
The rise of opioid prescriptions and associated deaths ('opioid epidemic') in North America has evoked worldwide discussions on the long-term efficacy and safety of long-term opioid therapy (LtOT) for chronic noncancer pain (CNCP). We discuss if the opioid epidemic is a real worldwide or a more North American phenomenon. We consider reasons of the opioid epidemic. We highlight differences in the appraisal of the evidence of recent systematic reviews on LtOT for CNCP of US and European authors. We discuss similarities and differences of recent North American and European guidelines on LtOT for chronic CNCP...
2016: Pain Management
Manabu Hayama, Hidekazu Suzuki, Takayuki Shiroyama, Motohiro Tamiya, Norio Okamoto, Ayako Tanaka, Naoko Morishita, Takuji Nishida, Takashi Nishihara, Tomonori Hirashima
BACKGROUND: Long-term oxygen therapy (LTOT) is sometimes prescribed for patients with advanced lung cancer who are potential candidates for chemotherapy. The aim of this study was to assess the usefulness of chemotherapy for patients with this disease who require LTOT. METHODS: The medical records of 40 patients with advanced lung cancer who received LTOT while undergoing systemic chemotherapy at our institution between January 2009 and December 2014 were retrospectively reviewed...
January 2016: Journal of Thoracic Disease
Julie R Gaither, Joseph L Goulet, William C Becker, Stephen Crystal, E Jennifer Edelman, Kirsha Gordon, Robert D Kerns, David Rimland, Melissa Skanderson, Amy C Justice, David A Fiellin
PURPOSE: For patients receiving long-term opioid therapy (LtOT), the impact of guideline-concordant care on important clinical outcomes--notably mortality--is largely unknown, even among patients with a high comorbidity and mortality burden (e.g., HIV-infected patients). Our objective was to determine the association between receipt of guideline-concordant LtOT and 1-year all-cause mortality. METHODS: Among HIV-infected and uninfected patients initiating LtOT between 2000 and 2010 through the Department of Veterans Affairs, we used Cox regression with time-updated covariates and propensity-score matched analyses to examine the association between receipt of guideline-concordant care and 1-year all-cause mortality...
May 2016: Journal of General Internal Medicine
Jay Suntharalingam, Sabrine Hippolyte, Vikki Knowles, Daryl Freeman, Irem Patel, Maxine Hardinge
The ability to provide oxygen in a patient's home can offer enormous benefits, including improvements in life expectancy when given in the appropriate setting. Confusingly, however, home oxygen is available in many forms, including long-term oxygen therapy (LTOT), ambulatory oxygen therapy (AOT), palliative oxygen therapy (POT) and short-burst oxygen therapy (SBOT)-each with varying degrees of supporting evidence. The British Thoracic Society (BTS) has recently published new guidance on home oxygen therapy, after collating the available evidence...
2016: NPJ Primary Care Respiratory Medicine
Renu Khetan, Matthew Hurley, Sarah Spencer, Jayesh M Bhatt
BACKGROUND: Bronchopulmonary dysplasia (BPD), also known as chronic lung disease of prematurity or chronic neonatal lung disease, is a major cause of respiratory illness in premature babies. Newborn babies survive at gestational ages of 23 to 26 weeks, earlier than when BPD was first described. New mechanisms of lung injury have therefore emerged and the clinical and pathological characteristics of pulmonary involvement have changed. PURPOSE: Improved neonatal intensive care unit modalities have increased survival rates; the overall prevalence of the condition, however, has not changed...
February 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Hanan A Tanash, Fredrik Huss, Magnus Ekström
BACKGROUND: Long-term oxygen therapy (LTOT) improves the survival time in hypoxemic chronic obstructive pulmonary disease. Despite warnings about potential dangers, a considerable number of patients continue to smoke while on LTOT. The incidence of burn injuries related to LTOT is unknown. The aim of this study was to estimate the rate of burn injury requiring health care contact during LTOT. METHODS: Prospective, population-based, consecutive cohort study of people starting LTOT from any cause between January 1, 1992 and December 31, 2009 in the Swedish National Register of Respiratory Failure (Swedevox)...
2015: International Journal of Chronic Obstructive Pulmonary Disease
U Marschall, H L'hoest, L Radbruch, W Häuser
BACKGROUND: No data are available on the prevalence and predictors of (high-dose) long-term opioid therapy (LTOT) and on abuse/addiction of prescribed opioids by patients with chronic non-cancer pain (CNCP) outside North America and Scandinavia. METHODS: We analysed randomly selected claims records of 870,000 persons (10% of insureds) in a large German medical health insurance organization during the fiscal year 2012. RESULTS: The prevalence of LTOT prescriptions (defined by at least one opioid prescription per quarter for at least three consecutive quarters) for CNCP was 1...
May 2016: European Journal of Pain: EJP
Yu Hara, Atsuya Takeda, Takahisa Eriguchi, Naoko Sanuki, Yousuke Aoki, Shuichi Nishimura, Tatsuji Enomoto, Masaharu Shinkai, Akihiko Kawana, Takeshi Kaneko
A major cause of death in patients undergoing long-term domiciliary oxygen therapy (LTOT) is lung cancer progression. In our institution, we actively perform stereotactic body radiotherapy (SBRT) on patients with early-stage non-small-cell lung cancer undergoing LTOT. In this study, we retrospectively analyzed the treatment efficacy and safety of SBRT for patients with T1-3N0M0 non-small-cell lung cancer who had been prescribed LTOT for treatment of chronic obstructive pulmonary disease (COPD). A total of 24 patients were studied...
January 2016: Journal of Radiation Research
Timm Greulich, Andreas Rembert Koczulla, Christoph Nell, Katharina Kehr, Claus F Vogelmeier, Dragan Stojanovic, Michael Wittmann, Konrad Schultz
BACKGROUND: Pulmonary rehabilitation improves exercise capacity, symptoms, and quality of life in chronic obstructive pulmonary disease (COPD) patients, and is therefore recommended in all stages of the disease. However, there are insufficient data on patients with very severe disease. OBJECTIVE: To describe the effect of an in-house multidisciplinary pulmonary rehabilitation program on patients with very severe COPD. METHODS: We performed a retrospective analysis of 544 consecutive patients with very severe COPD (FEV1 0...
2015: Respiration; International Review of Thoracic Diseases
Roberto W Dal Negro, Luca Bonadiman, Fernanda P Bricolo, Silvia Tognella, Paola Turco
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory condition which can lead to comorbidities of variable severity, cognitive dysfunction included. The role of supplemental oxygen in preventing COPD-induced cognitive deterioration is still debated, but only episodically investigated. The aim of this study was to compare the cognitive pattern of hypoxemic COPD subjects treated with long-term oxygen (LTOT) to that of patients of comparable severity assuming oxygen on irregular basis, and to normal reference values...
2015: Multidisciplinary Respiratory Medicine
T Reid, M Vennelle, M McKinley, P A MacFarlane, N Hirani, A J Simpson, Renata L Riha
BACKGROUND: Very little data exists on the prevalence and impact of sleep-disordered breathing (SDB) in patients with idiopathic pulmonary fibrosis (IPF). The aim of this study was to examine the impact of SDB on newly diagnosed IPF patients and explore associations with lung function parameters. METHODS: From 2005 to 2009, a cohort of 27 newly diagnosed patients with IPF underwent unattended polygraphy. All patients were diagnosed according to ATS 2000 diagnostic criteria and were not on supplemental oxygen or other treatment...
May 2015: Sleep & Breathing, Schlaf & Atmung
Emelie Ekkernkamp, Lena Welte, Claudia Schmoor, Sophie Emilia Huttmann, Michael Dreher, Wolfram Windisch, Jan Hendrik Storre
BACKGROUND: Correct measurement of PO₂ and PCO₂ is essential to establish appropriate therapy such as long-term oxygen therapy (LTOT) in patients suffering from respiratory failure. OBJECTIVES: We aimed to compare common invasive and noninvasive methods for assessing blood gas components for spot check analysis. METHODS: Arterial (PaO₂, PaCO₂) and capillary blood gas (PCBGO2, PCBGCO2) measurements were taken consecutively in a randomized order and were compared with noninvasive measurements obtained from the transcutaneous monitoring of PO₂ and PCO₂ (PtcOv, PtcCO₂, sensor-temperature 44°C)...
2015: Respiration; International Review of Thoracic Diseases
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