SANTA MONICA, Calif.--A new study indicates that home oxygen use could save thousands of lives among patients with COPD.
According to the study, conducted by non-profit research organization Rand Corp., obstructive lung diseases, including asthma and chronic obstructive pulmonary disease, affect an estimated 12 to 50 million Americans, but patients with these diseases receive only about half of the recommended medical care.
For example, only 32 percent of COPD patients with baseline hypoxia received home oxygen, the study stated, estimating that increasing the number could prevent 27,000 to 57,000 deaths annually. COPD is the fourth leading cause of death in the U.S.
The study, published in the November issue of the medical journal Chest, also found that patients with asthma received about 67 percent of the care recommended for routine management of their illness, but only 48 percent of the care recommended when their condition worsened.
Meanwhile, the government is launching its own study of home oxygen therapy for COPD. The six-year, $28 million project--the largest randomized clinical trial of the subject--will be conducted by the National Heart, Lung and Blood Institute, one of the National Institutes of Health, and CMS.
During the trial, researchers at 14 clinical centers across the country will study approximately 3,500 patients with moderate COPD to determine whether supplemental oxygen will help them lead longer and better quality lives. The results will be used to determine whether to extend Medicare coverage of home oxygen treatment for those with moderate COPD. CMS currently covers home oxygen therapy only for COPD patients with a severe form of the disease.
"COPD is a devastating, highly disabling disease. The prospect that home oxygen therapy could lessen the disability of COPD and perhaps even prolong life when given earlier during the course of the disease is enticing, but we need more information to determine the risks and benefits," said NHLBI Director Elizabeth Nabel.
About 12 million adults in the country have been diagnosed with COPD, and approximately one million of those receive supplemental oxygen treatment. Another 12 million Americans are believed to be undiagnosed.
NHLBI and CMS previously collaborated on a landmark study that determined which patients with severe COPD are most likely to benefit from or suffer complications from lung volume reduction surgery. Findings from the National Emphysema Treatment Trial were reported in May 2003, and Medicare subsequently began coverage of the procedure based on the results.
Patient recruitment for the Long-term Oxygen Treatment Trial is expected to begin in late 2007. Participants will be randomly selected to receive or not to receive supplemental oxygen for three years. All participants will be periodically monitored; those who are not initially selected to receive oxygen will be prescribed oxygen if their blood oxygen levels worsen during the study period.
In March, Medicare announced that it would extend coverage of home oxygen treatment to Medicare-eligible patients enrolled in the study who would not otherwise be covered.
"Medicare is committed to ensure that beneficiaries have access to the most appropriate treatments based on the best available science," said CMS Chief Clinical Officer Barry Straube. "The results of this study will improve our understanding of the effects of oxygen treatment in a broader group of COPD patients and will help guide our policy decisions."