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Appropriate Home Oxygen Delivery Among Patients with Chronic Obstructive Pulmonary Disease

Award Number: F32HL186574
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS
PERIOD OF PERFORMANCE START DATE: 01/06/2027
PERIOD OF PERFORMANCE END DATE: 01/05/2028

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Appropriate Home Oxygen Delivery Among Patients with Chronic Obstructive Pulmonary Disease - PROJECT SUMMARY Evidence-based health care delivery improves patient safety, care quality, and value. Yet, adoption of current evidence, especially in the face of engrained clinical practice, is often difficult to achieve. Among patients with chronic obstructive pulmonary disease (COPD), home oxygen prescribing has been slow to align with current evidence due to strongly held beliefs about benefits, changing evidence with newer studies, and conflicting guidelines. Despite evidence from the landmark Long-Term Oxygen Treatment Trial (LOTT) showing no benefit of oxygen for patients with COPD and ambulatory hypoxemia alone, oxygen is commonly prescribed for this indication or continued after an acute illness without evidence of ongoing need. This inappropriate home oxygen prescribing exposes patients to an increased risk of fires and falls and increases costs without clinical benefit. In 2020, the Veterans Health Administration (VHA) implemented a novel policy-based approach in the form of a Home Oxygen Directive that outlined explicit, evidence-based criteria for home oxygen use. However, its effect on clinical practice is unknown. Grounded in the Practical, Robust Implementation and Sustainability Model (PRISM), the objectives of this study are to 1) assess the effect of the Directive on appropriate home oxygen prescribing and patient safety (Aim 1); and 2) assess the adoption of the Directive across VA facilities using a sequential explanatory mixed methods study (Aim 2). Aim 1 will be completed using a national cohort of patients with COPD newly started on home oxygen identified from VHA administrative data. In Aim 2, I will survey clinicians responsible for home oxygen delivery at each VHA site and conduct qualitative interviews with a subset of these clinicians to explore perspectives around the Directive’s implementation. This proposal will yield insights into the impact of the VA Home Oxygen Directive on appropriate home oxygen prescribing and patient safety that can be applied to other health systems. I will achieve my training aims of applying implementation frameworks in health policy analysis, gaining experience in quasi-experimental study design, and conducting qualitative research in a mixed methods study through completion of this research project, formal coursework and seminars, and direct guidance from my mentors. I have deliberately assembled a collaborative mentorship team with a strong track record of mentoring trainees to successful physician scientist careers, broad expertise in biostatistics and qualitative methods, and who are current leaders in U.S. health policy. I will be well supported in my training environment with access to resources both at the University of Washington and the VA Health Systems Research Center of Innovation for Veteran-Centered and Value-Driven Care. Completing these research and training aims will prepare me to submit a successful career development award and achieve my long-term goal of becoming an independent investigator studying health care delivery for patients with COPD with a focus on evidence-based and high-value care.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $91,324 )
2026	2026	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Lung Diseases Research	000	1	7/7/2026	NEW	$91,324
														Subtotal = $91,324

Grand Total All Awards = $91,324

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Appropriate Home Oxygen Delivery Among Patients with Chronic Obstructive Pulmonary Disease

Award Number: F32HL186574

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

PERIOD OF PERFORMANCE START DATE: 01/06/2027

PERIOD OF PERFORMANCE END DATE: 01/05/2028

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