Outcome measures for palliative oxygen therapy: relevance and practical utility

Abstract

Dyspnea is a common symptom in many advanced malignant and non-malignant diseases and often is refractory to the usual therapies. In such circumstances palliative care approaches are necessary and among them palliative care oxygen therapy can be applied although currently its effectiveness is rather uncertain. Palliative oxygen therapy can be given on either continuous basis or on demand. Often the continuous palliative oxygen therapy is seen as long-term oxygen therapy although their aims are rather different. Palliative oxygen therapy was evaluated in populations with mixed underlying diseases, with outcome measures not only the most appropriate for the setting and therefore these limitations might have influenced the overall perceived therapeutic benefit. Therefore an evaluation of this method in subsets defined based on the etiology and pathogenic mechanisms and with appropriate outcome measures would help to better define the criteria for its indication and would increase its acceptability.

Keywords::

• oxygen therapy
• chronic obstructive pulmonary disease
• lung cancer
• palliative care dyspnea

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Oxygen therapy is usually prescribed for patients with chronic respiratory failure as home oxygen therapy in order to improve their survival and is most commonly administered continuously (at least 15/24 h).

• Palliative oxygen therapy is mainly aimed at treating refractory dyspnea in patients with both malignant and non-malignant conditions and is an underused method of therapy.

• It can be prescribed as both continuous or on demand.

• The effectiveness of palliative oxygen therapy is uncertain, and this can be due to the fact that the target populations that would benefit the most are not well defined, and because the outcome measures of effectiveness are not well standardized.

• If measures such as survival, quality of life, mood status, dyspnea or functional status would be evaluated, the benefits of palliative oxygen therapy would be better known and exploited.

Notes

Data taken from [1].