Smoking and home oxygen therapy: a review and consensus statement from a multidisciplinary Swedish taskforce.


Journal

European respiratory review : an official journal of the European Respiratory Society
ISSN: 1600-0617
Titre abrégé: Eur Respir Rev
Pays: England
ID NLM: 9111391

Informations de publication

Date de publication:
31 Jan 2024
Historique:
received: 28 09 2023
accepted: 02 12 2023
medline: 1 2 2024
pubmed: 1 2 2024
entrez: 31 1 2024
Statut: epublish

Résumé

Home oxygen therapy (HOT) improves survival in patients with hypoxaemic chronic respiratory disease. Most patients evaluated for HOT are former or active smokers. Oxygen accelerates combustion and smoking may increase the risk of burn injuries and fire hazards; therefore, it is considered a contraindication for HOT in many countries. However, there is variability in the practices and policies regarding this matter. This multidisciplinary Swedish taskforce aimed to review the potential benefits and risks of smoking in relation to HOT, including medical, practical, legal and ethical considerations. The taskforce of the Swedish Respiratory Society comprises 15 members across respiratory medicine, nursing, medical law and ethics. HOT effectiveness and adverse risks related to smoking, as well as practical, legal and ethical considerations, were reviewed, resulting in five general questions and four PICO (population-intervention-comparator-outcome) questions. The strength of each recommendation was rated according to the GRADE (grading of recommendation assessment, development and evaluation) methodology. General questions about the practical, legal and ethical aspects of HOT were discussed and summarised in the document. The PICO questions resulted in recommendations about assessment, management and follow-up of smoking when considering HOT, if HOT should be offered to people that meet the eligibility criteria but who continue to smoke, if a specific length of time of smoking cessation should be considered before assessing eligibility for HOT, and identification of areas for further research. Multiple factors need to be considered in the benefit/risk evaluation of HOT in active smokers. A systematic approach is suggested to guide healthcare professionals in evaluating HOT in relation to smoking.

Sections du résumé

BACKGROUND BACKGROUND
Home oxygen therapy (HOT) improves survival in patients with hypoxaemic chronic respiratory disease. Most patients evaluated for HOT are former or active smokers. Oxygen accelerates combustion and smoking may increase the risk of burn injuries and fire hazards; therefore, it is considered a contraindication for HOT in many countries. However, there is variability in the practices and policies regarding this matter. This multidisciplinary Swedish taskforce aimed to review the potential benefits and risks of smoking in relation to HOT, including medical, practical, legal and ethical considerations.
METHODS METHODS
The taskforce of the Swedish Respiratory Society comprises 15 members across respiratory medicine, nursing, medical law and ethics. HOT effectiveness and adverse risks related to smoking, as well as practical, legal and ethical considerations, were reviewed, resulting in five general questions and four PICO (population-intervention-comparator-outcome) questions. The strength of each recommendation was rated according to the GRADE (grading of recommendation assessment, development and evaluation) methodology.
RESULTS RESULTS
General questions about the practical, legal and ethical aspects of HOT were discussed and summarised in the document. The PICO questions resulted in recommendations about assessment, management and follow-up of smoking when considering HOT, if HOT should be offered to people that meet the eligibility criteria but who continue to smoke, if a specific length of time of smoking cessation should be considered before assessing eligibility for HOT, and identification of areas for further research.
CONCLUSIONS CONCLUSIONS
Multiple factors need to be considered in the benefit/risk evaluation of HOT in active smokers. A systematic approach is suggested to guide healthcare professionals in evaluating HOT in relation to smoking.

Identifiants

pubmed: 38296345
pii: 33/171/230194
doi: 10.1183/16000617.0194-2023
pmc: PMC10828833
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright ©The authors 2024.

Déclaration de conflit d'intérêts

Conflict of interest: The authors have no conflict of interest relevant for this study to declare.

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Auteurs

Zainab Ahmadi (Z)

Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund University, Lund, Sweden zai.ahmd@gmail.com.

Joar Björk (J)

Centre for Research Ethics and Bioethics (CRB), Uppsala University, Uppsala, Sweden.
Stockholm Centre for Healthcare Ethics (CHE), LIME, Karolinska Institute, Stockholm, Sweden.

Hans Gilljam (H)

Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.

Madhuri Gogineni (M)

Stockholms Sjukhem, Palliative Home Care and Hospice Wards, Stockholm, Sweden.

Torbjörn Gustafsson (T)

Department of Respiratory Medicine and Allergy, University Hospital of Umeå, Umeå, Sweden.

Michael Runold (M)

Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden.
Department of Medicine Solna, Respiratory Medicine Unit, Karolinska Institute, Stockholm, Sweden.

Thomas Ringbæk (T)

Allergy and Lung Clinic, Elsinore, Denmark.

Josefin Wahlberg (J)

Department of Medicine, Blekinge Hospital, Karlskrona, Sweden.

Lotta Wendel (L)

Faculty of Health and Society, Malmö University, Malmö, Sweden.

Magnus Ekström (M)

Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund University, Lund, Sweden.

Classifications MeSH