title: Long-term oxygen therapy in chronic respiratory failure: a Multicenter Italian Study on Oxygen Therapy Adherence (MISOTA).
abstract: BACKGROUND
  The adherence to the prescribed oxygen therapy is difficult to obtain for patients on long-term oxygen therapy (LTOT). There is little information on the modalities of oxygen utilisation for patients on LTOT who are using liquid oxygen in real life.
  
  
  OBJECTIVE
  Evaluation of the behaviour and the knowledge regarding LTOT in a large group of patients mainly using liquid oxygen.
  
  
  METHODS
  Questionnaire administered to consecutive outpatients on domiciliary LTOT for at least 6 months referring to one of 20 clinics throughout Italy. Blinded to this result, the physician who cared for the patient completed another questionnaire.
  
  
  RESULTS
  We evaluated 1504 patients (mean age 71.6 years; males 64%; 74% suffering from COPD). Most respondents (93%) used liquid oxygen with mobile device. Fifteen per cent of patients had a prescribed length of oxygen therapy less than 15 h/day; 21% reported to practice oxygen for less than 15 h/day. Patients reported using oxygen for less hours than had been prescribed during the day at rest (P=0.02, k=0.80) during exercise (P=0.002, k=0.72) and at night (P=0.0036, k=0.77). There was no difference between the flow prescribed by the physician and that known and practised by the patient at rest or during sleep; during exercise the flow reported by patients was lower than that prescribed by the physician. Patients used in the night but not at rest or during exercise, a lower level of oxygen flow than what they knew had been prescribed. Fifty-five per cent of patients received indications to modify the oxygen flow in the various situations of life. Liquid oxygen was almost always useful to decrease breathlessness. Most (84%) patients possessed a mobile device, but only 40% declared they used it daily, 'shame' being indicated as the principal barrier. On the physicians' side, we found that the criteria used in prescribing did not always correspond to evidence-based recommendations.
  
  
  CONCLUSIONS
  The widespread use of liquid oxygen did not automatically assure optimal adherence to the prescribed treatment as regards times and modality of oxygen use. A better education of patients, relatives, and the general public, as well as increased self-assessment on the part of health caregivers would improve the practice of LTOT in Italy.
authors.affiliation: Pneumologia, Fondazione S Maugeri I.C.C.R.S Istituto Scientifico di Tradate VA, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Neri
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Melani
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Miorelli
authors.forename: Doriana
authors.initials: D
authors.lastname: Zanchetta
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Bertocco
authors.forename: Cristina
authors.initials: C
authors.lastname: Cinti
authors.forename: Piero Aldo
authors.initials: PA
authors.lastname: Canessa
authors.forename: Piersante
authors.initials: P
authors.lastname: Sestini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006699:Home Care Services / Q000592:standards; D006801:Humans; D007558:Italy; D008173:Lung Diseases, Obstructive / Q000628:therapy*; D008297:Male; D010102:Oxygen Inhalation Therapy; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000592:standards; D012131:Respiratory Insufficiency / Q000628:therapy*; D012646:Self Administration; D011795:Surveys and Questionnaires