4.4 Article

A qualitative study of patient and carer experiences with home respiratory therapies: Long-term oxygen therapy and home mechanical ventilation

期刊

PULMONOLOGY
卷 28, 期 4, 页码 268-275

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ELSEVIER
DOI: 10.1016/j.pulmoe.2021.05.010

关键词

Long-term oxygen therapy; Home mechanical ventilation; Focus groups; Patient experience; Quality of care; Chronic care model

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This study explores the experience of patients and carers receiving home respiratory therapy (HRT), particularly long-term oxygen therapy (LTOT) and home mechanical ventilation (HMV). The findings indicate that patients and carers generally have a positive perception of HRT, acknowledging significant improvements in quality of life. However, there are areas in healthcare that require improvement, specifically in terms of navigability and coordination between different healthcare teams.
Studies exploring the experience of patients receiving home(HRT), such as long-term oxygen therapy (LTOT) and home mechanical ventilation (HMV), are still limited. This study focused on patients' and carers' experience with LTOT and HMV. An exploratory, cross-sectional qualitative study, using semi-structured focus groups, was carried out with 18 patients receiving HRT (median 71y, 78% male, 56% on both LTOT and HMV) and 6 carers (median age 67y, 67% female). Three focus groups were conducted in three regions of Portugal. Thematic analysis was performed by two independent researchers. Patients' and carers' experience was reflected in seven major topics, linked to specific time points and settings of the treatment: Initial symptoms/circumstances (n = 41), Prescription (n = 232), Implementation (n = 184), Carer involvement (n = 34), Quality of life impact (n = 301), Health care support/navigability (n = 173) and Suggestions (n = 14). Our findings demonstrate a general good perception of the HRT by patients and carers recognizing a significative quality of life impact improvement, while identifying specific points where improvements in healthcare are needed, particularly about navigability issues, articulation between the hospital, primary care and homecare teams, especially regardingprescriptionrenewal. This knowledge is crucial to promote a long-term HRT adherence and to optimize HRT delivery in line with patients' experience, needs, and values. Moreover, these key points can inform the development of a specific patient-reported experience measure (PREM) for patients on HRT, which is not currently available, and foster a more integrated respiratory care model. (C) 2021 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L.U.

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