Recommended Citation
Gunasekera P, Narula G, Saxena R, Wankowski D, Riutta S, Gesell L. Comparison of Patient Treatment Compliance and Adherence in Monoplace Versus Multiplace Hyperbaric Oxygen Therapy Chambers. Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Abstract
Background/Significance:
Hyperbaric oxygen therapy (HBOT) requires substantial patient commitment, often 20–40+ outpatient sessions, and premature discontinuation along with missed treatments are associated with poorer wound healing and limb salvage outcomes. Psychological and social determinants of health (SDOH) including anxiety, claustrophobia, and social connectedness, may influence adherence. Multiplace chambers allow peer interaction and continuous staff support that may mitigate anxiety, whereas monoplace chambers may increase perceived isolation. Limited data exists comparing treatment completion between chamber types.
Purpose:
To compare treatment compliance between monoplace and multiplace HBOT chambers and explore associations between adherence metrics in an outpatient hyperbaric program.
Methods:
A retrospective chart review was conducted on adult outpatients receiving HBOT at 3 monoplace sites and 1 multiplace site from 09/01/21 to 09/30/25. Demographics, indications, prescribed and completed sessions, no-shows, aborted runs, and anxiolytic use were collected. Statistical analysis utilized Chi-square, Fisher’s exact, and Wilcoxon rank-sum tests.
Results:
The cohort included 172 patients (monoplace n=110, multiplace n=62). Median prescribed sessions were higher in the monoplace group (40 [IQR 30–40] vs 30 [10–30], p<0.001). Median completed sessions were also higher in monoplace when compared to multiplace chambers (33 [21–40] vs 20 [4–30], p<0.001). No-show rates were significantly higher in monoplace (74.6%) vs. multiplace (48.4%; p=0.001). Aborted runs were more frequent in monoplace (17.3%) vs. multiplace (8.1%, p=0.19). When controlling for variability by limiting diagnosis to chronic refractory osteomyelitis, diabetic foot ulcer Wagner stage > 3, delayed radiation injury, and compromised surgical flap, similar treatment completion patterns were observed.
Conclusion:
Across all treated diagnoses in an outpatient HBOT cohort, monoplace patients were prescribed and completed more overall sessions but had higher no-show rates and aborted treatments. These findings suggest compliance challenges may be more prominent in the monoplace setting. Persistent trends after controlling diagnosis support the belief that chamber environment and associated social interaction may influence adherence behaviors. Prospective studies incorporating standardized anxiety and SDOH screening are warranted to guide targeted interventions aimed at improving treatment completion and outcomes.
Presentation Notes
Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Full Text of Presentation
wf_yes
Document Type
Oral/Podium Presentation
Comparison of Patient Treatment Compliance and Adherence in Monoplace Versus Multiplace Hyperbaric Oxygen Therapy Chambers
Background/Significance:
Hyperbaric oxygen therapy (HBOT) requires substantial patient commitment, often 20–40+ outpatient sessions, and premature discontinuation along with missed treatments are associated with poorer wound healing and limb salvage outcomes. Psychological and social determinants of health (SDOH) including anxiety, claustrophobia, and social connectedness, may influence adherence. Multiplace chambers allow peer interaction and continuous staff support that may mitigate anxiety, whereas monoplace chambers may increase perceived isolation. Limited data exists comparing treatment completion between chamber types.
Purpose:
To compare treatment compliance between monoplace and multiplace HBOT chambers and explore associations between adherence metrics in an outpatient hyperbaric program.
Methods:
A retrospective chart review was conducted on adult outpatients receiving HBOT at 3 monoplace sites and 1 multiplace site from 09/01/21 to 09/30/25. Demographics, indications, prescribed and completed sessions, no-shows, aborted runs, and anxiolytic use were collected. Statistical analysis utilized Chi-square, Fisher’s exact, and Wilcoxon rank-sum tests.
Results:
The cohort included 172 patients (monoplace n=110, multiplace n=62). Median prescribed sessions were higher in the monoplace group (40 [IQR 30–40] vs 30 [10–30], p<0.001). Median completed sessions were also higher in monoplace when compared to multiplace chambers (33 [21–40] vs 20 [4–30], p<0.001). No-show rates were significantly higher in monoplace (74.6%) vs. multiplace (48.4%; p=0.001). Aborted runs were more frequent in monoplace (17.3%) vs. multiplace (8.1%, p=0.19). When controlling for variability by limiting diagnosis to chronic refractory osteomyelitis, diabetic foot ulcer Wagner stage > 3, delayed radiation injury, and compromised surgical flap, similar treatment completion patterns were observed.
Conclusion:
Across all treated diagnoses in an outpatient HBOT cohort, monoplace patients were prescribed and completed more overall sessions but had higher no-show rates and aborted treatments. These findings suggest compliance challenges may be more prominent in the monoplace setting. Persistent trends after controlling diagnosis support the belief that chamber environment and associated social interaction may influence adherence behaviors. Prospective studies incorporating standardized anxiety and SDOH screening are warranted to guide targeted interventions aimed at improving treatment completion and outcomes.
Affiliations
Aurora St. Luke’s Medical Center, Aurora UW Medical Group, Aurora Sinai Medical Center