Physician Practices for Prescribing Supplemental Oxygen in the Palliative Care Setting

Dyspnea is a disturbing symptom frequently experienced by patients with advanced cancer. Supplemental oxygen is commonly used as palliative treatment in this setting. We undertook a telephone survey of physicians authorized to prescribe home oxygen according to eligibility criteria determined by publicly funded home care service. A clinical case was varied by addition of one to four factors: presence or absence of dyspnea, hypoxemia, private insurance, and a “dummy” factor to give 20 scenarios. Respondents decided whether to prescribe oxygen and rated degree of benefit oxygen would provide. Physician response rate was 81%. Respondents were in complete agreement in 44% of scenarios. The presence of breathlessness or hypoxemia affected the decision to prescribe oxygen; availability of private insurance did not. There was a wide range of perceived benefits to oxygen prescription. In conclusion, physician practices for prescribing supplemental oxygen in the palliative care setting are variable. Further research is needed.