Does palliative home oxygen improve dyspnoea? A consecutive cohort study.

Published

Journal Article

Palliative oxygen for refractory dyspnoea is frequently prescribed, even when the criteria for long-term home oxygen (based on survival, rather than the symptomatic relief of breathlessness) are not met. Little is known about how palliative home oxygen affects symptomatic breathlessness. A 4-year consecutive cohort from a regional community palliative care service in Western Australia was used to compare baseline breathlessness before oxygen therapy with dyspnoea sub-scales on the symptom assessment scores (SAS; 0-10) 1 and 2 weeks after the introduction of oxygen. Demographic and clinical characteristics of people who responded were included in a multi-variable logistic regression model. Of the study population (n = 5862), 21.1% (n = 1239) were prescribed oxygen of whom 413 had before and after data that could be included in this analysis. The mean breathlessness before home oxygen was 5.3 (SD 2.5; median 5; range 0-10). There were no significant differences overall at 1 or 2 weeks (P = 0.28) nor for any diagnostic sub-groups. One hundred and fifty people (of 413) had more than a 20% improvement in mean dyspnoea scores. In multi-factor analysis, neither the underlying diagnosis causing breathlessness nor the demographic factors predicted responders at 1 week. Oxygen prescribed on the basis of breathlessness alone across a large population predominantly with cancer does not improve breathlessness for the majority of people. Prospective randomised trials in people with cancer and non-cancer are needed to determine whether oxygen can reduce the progression of breathlessness compared to a control arm.

Full Text

Cited Authors

  • Currow, DC; Agar, M; Smith, J; Abernethy, AP

Published Date

  • June 2009

Published In

Volume / Issue

  • 23 / 4

Start / End Page

  • 309 - 316

PubMed ID

  • 19304806

Pubmed Central ID

  • 19304806

Electronic International Standard Serial Number (EISSN)

  • 1477-030X

International Standard Serial Number (ISSN)

  • 0269-2163

Digital Object Identifier (DOI)

  • 10.1177/0269216309104058

Language

  • eng