Trends in long-term oxygen therapy for COPD in Denmark from 2001 to 2010

Abstract

Objectives: To evaluate changes in demographics, incidence, prevalence, treatment modalities, and survival of COPD patients on long-term oxygen therapy (LTOT) from year 2001-2010 in Denmark.

Methods: All 14,965 COPD patients with COPD treated LTOT in Denmark in the period 2001-2010.

Results: During the study period, the incidence and prevalence of COPD patients on LTOT increased from 30.5 to 32.2 per 100.000, and from 42.0 to 48.1 per 100.000, respectively. Mean age of patients increased from 73.4 to 74.8 years, P < 0.001. An increasing number of patients were prescribed LTOT in connection with discharge after hospitalisation for an exacerbation (2001 vs. 2010: 76.5% vs. 91.7%, P < 0.001); were prescribed oxygen 15-24 h/day (85.8% vs. 89.5%, P < 0.001); had mobile oxygen (56.4% vs. 94.2%, P < 0.001), and stopped LTOT alive within 6 months (20.6% vs. 30.8%, P < 0.001). Ninety-nine percent of the patients received oxygen concentrator or liquid oxygen with no change in the study period (P = 0.66). The median survival on LTOT increased insignificantly from 16.5 to 17.8 months (P = 0.12). Women had a lower risk of dying compared with men, with an adjusted hazard ratio of 0.81 (95% confidence interval (CI) 0.78-0.84), P < 0.001). During the study period, the risk of death for women, compared to men, decreased significantly with a hazard ratio of 0.978 (95% CI: 0.964-0.992) per calendar year.

Conclusions: The incidence of COPD patients on LTOT in Denmark has levelled of during recent years, and the quality of prescribing LTOT and follow up has improved. Women had better survival than men, and this difference has increased during the study period.

Keywords: COPD; Oxygen therapy; Quality control; Survival.

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