Perspectives on oxygen use among individuals living with chronic hypoxemia in a low-resource setting

SUMMARY OBJECTIVE To describe experiences with oxygen therapy and barriers and facilitators to long-term oxygen therapy (LTOT) among individuals living with chronic hypoxemia in a tertiary referral hospital in Eldoret, Kenya. DESIGN A qualitative study using semi-structured interviews with individuals living with chronic hypoxemia. Interview transcripts were analysed using a phenomenological approach for thematic analysis. RESULTS We interviewed 16 participants (50% female), 6 (37.5%) of whom had home oxygen. Five emergent themes were identified: 1) limited knowledge regarding hypoxemia and oxygen therapy, 2) positive impact of oxygen therapy on symptoms, 3) perceived poor communication from health care providers, 4) mixed preference or perceived need for LTOT, and 5) cost impedes access to LTOT. Facilitators for LTOT include benefit of oxygen supplementation on symptoms and a strong desire to use LTOT. Barriers include lack of knowledge around hypoxemia and oxygen therapy, unclear communication regarding medical conditions or treatment plans, and cost. CONCLUSION This qualitative study helped identify key facilitators and barriers for implementation of LTOT in a low-resource setting. It also underscores the need for interventions designed to improve patient and provider knowledge on chronic hypoxemia and LTOT and to identify implementation strategies and policies which can address system-level barriers.