The role of pulse oximeter in anxiety and exacerbations in COPD patients: A prospective observational study

Pulse oximeter is commonly used by chronic obstructive pulmonary disease (COPD) patients for long-term oxygen therapy (LTOT) to monitor oxygen levels. This study investigated the association between oximeter use, anxiety severity, symptom burden, and healthcare utilization in this population.

This prospective observational study included 110 individuals with COPD who underwent LTOT. Data were collected on pulmonary function, modified Medical Research Council (mMRC) scores, and daily pulse oximeter use. Anxiety severity was assessed using the Beck Anxiety Inventory (BAI). Healthcare utilization in the previous year, including outpatient-treated and inpatient-treated exacerbations, intensive care unit admissions, and non-exacerbation-related hospital admissions, was analyzed. Linear regression analysis was performed to identify the independent predictors of nonexacerbation-related hospital admissions.

Among the participants, 68 (61.8%) reported using a home pulse oximeter. There were no significant differences in BAI scores (p= 0.678), oxygen therapy duration (p= 0.530), or mMRC scores (p= 0.251) between the groups. However, non-users had significantly higher rates of non-exacerbation-related hospital admissions than users (p< 0.001). In multivariable analysis, not using pulse oximeter independently predicted more non-exacerbationrelated admissions (B= 1.63, 95% CI: 0.94-2.32, p< 0.001), whereas anxiety and physiological measures were not significant.

Pulse oximeter use was not associated with anxiety or symptom severity among the patients with COPD receiving LTOT. However, non-use of pulse oximeter was independently associated with increased non-exacerbation-related hospital admissions. These findings suggest that pulse oximeter may support patient self-management and reduce unnecessary healthcare utilization, without contributing to anxiety.