Current situation and problems of home oxygen therapy (HOT) in the medical sphere with a population of two million people in Japan]

The current circumstances of patients treated with home oxygen therapy (HOT) for respiratory failure are understood relatively well, whereas those of HOT patients with heart failure has not been extensively examined. Furthermore, investigation of the fundamental realities of disease checkups cooperation between specialist hospitals and clinics regarding HOT patients has not been satisfactory. For these reasons, we attempted to clarify the circumstances of HOT patients at clinics, respiratory specialist hospitals, and cardiovascular specialist hospitals, in the context of those who work in the medical sphere in Japan (approx. 2 million people).An epidemiological survey was simultaneously sent to district clinics, respiratory specialist hospitals, and cardiovascular specialist hospitals, all located in Tochigi Prefecture in Japan, and which were anticipated to be involved in HOT.HOT was widely performed in all respiratory specialist hospitals, but only in 55% of clinics and in 67% of cardiovascular specialist hospitals. Among the total number of patients given HOT, the rate of patients with heart failure was 15%, 80% of whom had left-sided heart failure. This value was five times higher than that reported in a nationwide investigation in Japan. Since patients with advanced heart failure were highly comorbid with sleep-disordered breathing (SDB), non-invasive ventilation with continuous positive airway pressure (CPAP) instead of HOT was frequently given to these patients as first-line therapy. Checkups cooperation appeared relatively close among respiratory specialist hospitals, but not between cardiovascular specialist hospitals and district clinics.