Annals of Thoracic Medicine (Jan 2025)

Adherence and influencing factors of high-flow nasal cannula humidified oxygen therapy in elderly patients with stable chronic obstructive pulmonary disease: A meta-analysis

  • Yang Yang,
  • Ting-Ting Liu,
  • Dong-Mei Li,
  • Xue-Ling Ren,
  • Zheng Luo,
  • Xue-Li Chen,
  • Ying-Zhen Du,
  • Yan-Shuang Cheng

DOI
https://doi.org/10.4103/atm.atm_151_24
Journal volume & issue
Vol. 20, no. 1
pp. 49 – 55

Abstract

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OBJECTIVE: The objective of the study was to systematically evaluate and perform a meta-analysis on the adherence to high-flow nasal cannula (HFNC) humidified oxygen therapy and its influencing factors in elderly patients with stable chronic obstructive pulmonary disease (COPD). METHODS: Relevant literature on HFNC and COPD was retrieved from PubMed, EMbase, Web of Science, and Cochrane Library databases. Cross-sectional studies, case–control studies, and cohort studies were included. Screening and quality assessment were conducted using Endnote X9 software. Quality scores were assigned using the Newcastle–Ottawa Scale and the AHRQ assessment tool. Basic information, sample size, and adherence-related factors were extracted, and heterogeneity and publication bias were assessed. RESULTS: A total of 321 articles were initially identified, with 8 English articles involving 325 patients included after screening. Quality assessment yielded five high-quality articles (score > 8), two medium-quality articles (score = 7), and one low-quality article (score = 6). Meta-analysis results showed a COPD patient HFNC adherence rate of 32.7%. Negative factors included the number of acute exacerbations (odds ratio [OR] =2.17), adverse reactions (OR = 4.13), regular follow-up (OR = 9.45), educational level (OR = 5.38), and concurrent medications (OR = 4.71). Positive factors included age < 70 years (OR = 0.45), duration of use (OR = 0.30), inhalation technique (OR = 0.31), treatment satisfaction (OR = 0.35), and adverse reactions (OR = 0.15). Funnel plot and Egger’s test results indicated minimal publication bias. CONCLUSION: Adherence to HFNC in elderly COPD patients is relatively low, influenced by negative factors such as the number of acute exacerbations, adverse reactions, regular follow-up, educational level, and concurrent medications. Positive factors include age < 70 years, duration of use, inhalation technique, treatment satisfaction, and adverse reactions.

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