Physician practices for prescribing supplemental oxygen in the palliative care setting.
Dyspnea is a disturbing symptom frequently experienced by patients with advanced cancer. Supplemental oxygen is commonly used as palliative treatment in this setting. We undertook a telephone survey of physicians authorized to prescribe home oxygen according to eligibility criteria determined by publicly funded home care service. A clinical case was varied by addition of one to four factors: presence or absence of dyspnea, hypoxemia, private insurance, and a "dummy" factor to give 20 scenarios. Respondents decided whether to prescribe oxygen and rated degree of benefit oxygen would provide. Physician response rate was 81%. Respondents were in complete agreement in 44% of scenarios. The presence of breathlessness or hypoxemia affected the decision to prescribe oxygen; availability of private insurance did not. There was a wide range of perceived benefits to oxygen prescription. In conclusion, physician practices for prescribing supplemental oxygen in the palliative care setting are variable. Further research is needed.
Stringer
Elizabeth
E
Department of Medicine, Queen Elizabeth II Health Sciences Centre, Capital District Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada.
McParland
Colm
C
Hernandez
Paul
P
D001291:Attitude of Health Personnel; D016000:Cluster Analysis; D003657:Decision Making; D004417:Dyspnea / Q000209:etiology / Q000628:therapy*; D004608:Eligibility Determination; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000628:therapy; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D009674:Nova Scotia; D010102:Oxygen Inhalation Therapy / Q000706:statistics & numerical data*; D010166:Palliative Care / Q000706:statistics & numerical data*; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055656:Prescriptions / Q000706:statistics & numerical data*; D018454:Spouses / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome