Authors' objectives:

This report presents the results of a comprehensive literature review, prepared in response to a request from the Quebec Ministry of Health and Social Services to examine the available evidence about the indications, clinical efficiency, and cost-effectiveness of liquid oxygen therapy as well as the implications on the organization of and access to the home oxygen program in Quebec.

Authors' results and conclusions: Although there are no published clinical indications for the use of liquid oxygen systems at home, the prescription criteria of the available guidelines are based on patients mobility and usage. The lighter liquid oxygen systems are recommended for LTOT-dependent patients who need to go outside their home on a regular basis. There are no existing data which would indicate that liquid oxygen systems allow for extended daily duration of therapy or for improved quality of life in comparison to other oxygen supply systems (portable or stationary). Furthermore, there is limited evidence that this technology is more user-friendly and advantageous than the compressed gas systems. Comparative costs were reported in one study conducted in Sweden which reveals that liquid oxygen is four times as expensive as the standard therapy (concentrator plus portable cylinder). Utilization of liquid oxygen systems and access to this treatment vary within and across jurisdictions, and depend on the patients insurance coverage. In Canada, the use of liquid oxygen systems is higher in Ontario where it is covered by the provincial Home Oxygen Program. In Qubec, given the relatively higher cost and clinical concerns about added benefit, liquid oxygen systems are offered in the public system only as a traitement dexception to patients who spend lengthy periods of time out of their home either for work or for leisure or need high flow rates. Nevertheless, patients who wish to use these systems can buy one directly from a supplier. New systems of portable oxygen supply, such as a portable concentrator that has been developed in Montreal and is being tested for clinical use, may in the future compete as alternatives to liquid oxygen therapy.

Authors' recommendations: There is very limited information about the effectiveness of liquid oxygen therapy in comparison to compressed gas delivery systems in terms of enhanced patient compliance, mobility, or quality of life. A small minority of patients with chronic obstructive pulmonary disease (COPD) on long term oxygen therapy (LTOT) who have active lifestyles would likely benefit from the enhanced portability of liquid oxygen therapy. The identification of clinical and social indications or assessment criteria for the use of liquid oxygen therapy should be determined through a process of consensus amongst respirologists and decision-makers in Quebec, within the context of developing overall guidelines for home oxygen programs.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.aetmis.gouv.qc.ca/

Year Published: 2005

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Agence d'évaluation des technologies et des modes d'intervention en santé

Contact Address: 2021, avenue Union, Bureau 10.083,Montreal, Quebec H3A S29, Canada.Tel: +1 514 873 2563; Fax: +1 514 873 1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: Agence d'Evaluation des Technologies et des Modes d'Intervention en Sante (AETMIS)