Utility and outcomes among Indigenous and non-Indigenous patients requiring domiciliary oxygen therapy in the regional and rural Australian population.

Abstract

To evaluate the utility and outcomes for Indigenous and non-Indigenous patients requiring domiciliary oxygen therapy. Retrospective study. Patients residing in the regional and rural Top End Health Service region of the Northern Territory of Australia. Indigenous and non-Indigenous patients prescribed domiciliary oxygen therapy between 2018 and 2020. Demographics and clinical indication for domiciliary oxygen therapy and mortality were analysed. Differences between Indigenous patients requiring domiciliary oxygen therapy in comparison with their non-Indigenous counterparts. Of the 199 study participants, the majority were male (51%), non-Indigenous (77%) and urban residents (72%). Overall chronic obstructive pulmonary disease was the most common indication for domiciliary oxygen therapy (51%) followed by palliative intent (22%). Indigenous patients were significantly younger (61 vs 73 years), with a higher proportion of males (62% vs 45%, P=.039) and remote residents (62% vs 8%, P<.001). Among Indigenous patients, a significantly greater proportion of domiciliary oxygen therapy was indicated for chronic obstructive pulmonary disease and bronchiectasis (16% vs 1%, P<.001). Among non-Indigenous patients, malignancies were a more common indication for domiciliary oxygen therapy. A similar proportion of Indigenous and non-Indigenous patients were prescribed domiciliary oxygen therapy for palliative intent (31% and 20%, P=.108); however, the underlying diagnosis differed significantly, with a greater proportion of chronic obstructive pulmonary disease among Indigenous patients (43% vs 13%, P=.030) and malignancy among the non-Indigenous patients (73% vs 43%, P=.050). Mortality and length of survival were not significantly different by Indigenous status. Linear regression showed longer survival with domiciliary oxygen therapy for chronic obstructive pulmonary disease. Indigenous Australian patients living in remote communities will likely derive the same benefits and outcomes of domiciliary oxygen therapy as non-Indigenous peers.