Oxigenoterapia domiciliar prolongada em indivíduos com doenças respiratórias crônicas: uma análise clínica-funcional, de adesão e custo

Abstract

Introduction: it is important to know the context and characterize the profile of users of longterm oxygen therapy (LTOT) in order to identify the need to implement guidelines for monitoring this therapy,as well as identifying the level of physical mobility of these patients to design optimized intervention strategies. Aims: 1. Assess the level of mobility in LTOT patients' life space and its relationship with clinical and functional outcomes; 2. Evaluate the adherence and prescription of LTOT compared to the criteria of the guidelines and analyze the direct cost of this therapy. Materials and methods: cross-sectional study performed with adult LTOT users to assess comorbidities (Charlson's index), mobility in the life space (Life Space Assessment), dyspnea level (mMRC), lung function (Spirometry), exercise capacity (6-minute step test), level of independence in activities of daily living- ADL’s (Katz index), health-related quality of life (EuroQol-5D), adherence to LTOT and cost of home oxygen users. Results: study 1 (life space mobility), involved 105 users of LTOT and identified a high prevalence (92%) of mobility restriction in the life space. Life space mobility was related to the number of comorbidities (rs = -0.32), dyspnea (rs = -0.56), ADL’s (rs = 0.55) and 6MWT (rs = 0.47). Exercise capacity and dyspnea were determinant predictors of mobility in the living space of LTOT users. In study 2, 102 participants were evaluated. A total of 64.2% of LTOT users were observed with the prescription outside the criteria for use recommendation, and approximately 20-42% of users with low adherence to medical prescription for LTOT use. In addition, a 109% increase in the monthly cost of electricity was observed in oxygen users via concentrator. Conclusion: LTOT users have restricted mobility in the living space, which shows the need for interventions that alleviate dyspnea and improve exercise capacity in this population. In addition, it is necessary to implement prescription protocols based on LTOT recommendations, and health education to improve LTOT users' adherence to prescription.