The Current Situation and Perspectives of long-term oxygen therapy and home mechanical ventilation: Physician survey in Japanese White Paper on Home Respiratory Care 2024

<bold>Background:</bold> More than fifteen years have passed since the first White Paper was published. <bold>Aims:</bold> To assess the current situation and perspectives of home respiratory care, physician survey was conducted from 2022 to 2023. <bold>Methods:</bold> The questionnaire was sent to 3,006 medical institutions (institutions accredited by the Japanese Respiratory Society 1,158 and general hospitals and clinics 1,848) and return rate was 20% and 16%, respectively. <bold>Results:</bold> The three most common diseases among patients receiving long-term home oxygen therapy (LTOT) (n = 11,191) were COPD 37%, pulmonary fibrosis 30%, and lung cancer 6%. 12% of patients used LTOT only during exertion. The patients receiving pulmonary rehabilitation in the hospital and outpatient settings accounted for 71% and 32%, respectively. Local care networks for LTOT were established by 30% of institutions. Advanced care planning was conducted in 47% of medical institutions. Regarding home mechanical ventilation (HMV), the three most common diseases among patients receiving NPPV (n=1,329) were neuromuscular disease (NMD) 29%, COPD 23%, and pulmonary tuberculosis sequelae (TBS) 8%, and tracheal positive pressure ventilation (TPPV) (n=321) were NMD 59%, COPD 4%, and TBS 2%, respectively. Local care networks for NPPV and TPPV were established by 66% and 56% of institutions, respectively. <bold>Conclusions:</bold> The quality of care for LTOT and HMV should be improved in continuity based on the evidence clarified in the new White Paper. It is necessary to monitor the trends of patients undergoing LTOT and HMV to adapt the respiratory care system accordingly.