Yi Zhang,Jing Yang＊,National Alliance for the Publicity of Hyperbaric Medicine

1Department of Hyperbaric Oxygen,Beijing Chao-Yang Hospital,Capital Medical University.

Abstract Objective:We launched the fourth national hyperbaric oxygen (HBO)medicine week publicity campaign in China to increase patients’and medical professionals’understanding of HBO medicine and expand the influence of HBO.Methods:The theme of 2019 was “Oxygen protects life,healthy China”.The main components of the campaign were free medical consultation,free HBO experience,and telemedicine lectures.At least one component was required for each participating hospital.Results: (1) In total,195 hospitals in 26 provinces,autonomous regions,and municipalities directly under the central government participated in the campaign.Shandong province of China had the highest number of hospitals in a single area(48 hospitals);(2)The free medical consultation was organized by the HBO department.In some hospitals,other medical professionals were also invited.Among all hospitals,up to 13 different HBO-related departments participated;(3) The free HBO experiences were held in some hospitals,and the number of experiences ranged from one to three per person;(4) Three telemedicine lectures involving a total of 8 live interactions were held in 55 different hospitals.Lecture videos were provided to play locally in hospitals without the setting necessary for live interactions.Conclusion:Our campaigns created a brand effect beginning in 2016.In the herein-described 2019 study,we considered the previous three campaigns and explored different methods of publicizing HBO medicine in China,including telemedicine.

Keywords:Hyperbaric oxygen,Telemedicine,Publicity campaign,medical consultation.

Background

Hyperbaric oxygen therapy (HBOT) is a treatment in which the patient breathes 100% oxygen while being exposed to environmental pressure of ＞1 atmosphere absolute [1].Therapeutic mechanisms of HBOT are based on elevation of both the partial pressure of inspired oxygen and of the hydrostatic pressure [2],such as increasing oxygen partial pressure and oxygen dispersion distance,narrowing the bubbles in the body,mitigating tissue edema,promoting wound healing,repairing nerve myelin sheath,treating late radiation injury,antimicrobial effects,etc.As recommended by the Tenth European Consensus Conference on Hyperbaric Medicine,the accepted indications for HBOT are carbon monoxide poisoning,open fractures with crush injury,radionecrosis or radiation-induced lesions,decompression illness,gas embolism,anaerobic and mixed bacterial infections,sudden deafness,delayed wound healing,compromised skin grafts and flaps,limb replantation,refractory chronic osteomyelitis,femoral head necrosis,burns,central retinal artery occlusion,pneumatosis cystoides intestinalis,sickle cell disease,interstitial cystitis,brain injury in highly selected patients,and neuroblastoma[3].The 2018 newly revised main contraindications for HBOT as established by the Hyperbaric Oxygen(HBO)Branch of the Chinese Medical Association are untreated pneumothorax,premature infants,and low-birth-weight infants[4].

The advantages of HBOT in China include the large quantity,wide distribution,and low price of the treatment,all of which provide convenience for patients [5].However,many patients and medical professionals lack a full understanding of HBO,partly because of insufficient propagation of this therapy.

Therefore,we launched the Fourth National HBO Medicine Week Publicity Campaign,which occurred from 24 June to 24 July 2019.The theme of 2019 was“Oxygen protects life,healthy China”.

Materials and methods

Popularization of the campaign

In 2018,a total of 79 hospitals in 20 provinces,autonomous regions,and municipalities of China,directly under the central government participated in the Third HBO Medicine Week Publicity Campaign.In 2019,we popularized the campaign through both the HBO professional WeChat group and new media such as the WeChat public account.

Components of the campaign

The main components of the campaign were a free medical consultation,free HBOT experience,and telemedicine lectures.At least one component was required for each participating hospital.

Preparation of promotional material

We provided unified templates of the theme posters,banners,flyers,and self-test tables for both hypoxia and a suboptimal health status.

Telemedicine lecture

We prepared three telemedicine lectures supported by the telemedicine center of Beijing Chao-Yang Hospital,Capital Medical University,Beijing,China.

Lecture 1.The first lecture was titled “Clinical Application of HBO Medicine” and was presented by Yi Zhang,Deputy Chief Physician,Department of HBO,Beijing Chao-Yang Hospital,Capital Medical University,Beijing,China.The main contents of this lecture were the concept,development history and indications for HBO medicine.

Lecture 2.The second lecture was titled “Application of HBO Medicine in Orthopaedics” and was presented by Nan Kang,Chief Physician,Department of Orthopaedics,Beijing Chao-Yang Hospital,Capital Medical University,Beijing,China.The main contents of this lecture were the application of HBO to cervical spondylosis,lumbar disc herniation and spinal cord injury.

Lecture 3.The third lecture was titled “Application of HBO Medicine in Central Nervous System Diseases”and was presented by Li-Ming Zhao,Chief Physician,Department of HBO,Beijing Chao-Yang Hospital,Capital Medical University,Beijing,China.The main contents of this lecture were the clinical application and treatment mechanism of HBO in cerebrovascular disease,brain trauma,central nervous system infection and radiation encephalopathy.

Results

Participating hospitals

In total,195 hospitals in 26 provinces,autonomous regions,and municipalities of China,directly under the central government participated in the campaign.The median number of hospitals among all geographical areas involved in the study was 5.5.The maximum number was 48 hospitals(Shandong Province of China)and the minimum number was 1 (Jiangxi Province,Gansu Province,Qinghai Province and Tibet Autonomous Region of China)(Figure 1).

Free medical consultation

The free medical consultations were organized in a local area by the HBO department.In some hospitals,other medical professionals were also invited.Among all hospitals,up to 13 different HBO-related departments participated:orthopedics,neurology,neurosurgery,dermatology,pediatrics,sports medicine,otolaryngology,geriatrics,endocrinology vascular surgery,cardiovascular medicine,Chinese medicine,emergency and stomatology.

Free HBO experience

The free HBO experiences were held in some hospitals,the experimenters were mainly hospital workers,family members and people with a suboptimal health status.The number of experiences per person ranged from 1 to 3.The most obvious effect of the HBO experience was improvement of long-term insomnia.

Telemedicine lecture

The lectures were broadcast in two forms:a live interactive format and a video format.The participants included HBO professionals,other medical professionals and patients.

Live interaction.Among the three lectures,8 live interactions with a mean of 8.45± 3.27 questions were held.A total of 55 different hospitals participated,with a mean of 13.75 ± 3.49 hospitals per live interaction.The maximum number of hospitals that participated in the live interaction among all areas was 13 (Shandong Province,China)(Figure 2).

Video broadcast.For hospitals without the conditions required for live interactions,we provided videos to play locally.

Discussion

China is one of the first countries to carry out HBOT and has the largest number of HBO chambers(＞5,000 in total) worldwide,with nearly 30,000 practitioners[6].

Although HBO medicine has continued to develop in China in recent years,many patients and medical professionals still lack an understanding of HBO,thus limiting the further development of HBO.

The main reason for clinicians’ insufficient understanding of HBO is that only a few elective courses and postgraduate courses on HBO are available in a small number of medical colleges.Knowledge of HBO is popularized mainly by holding study classes and reporting individual cases;however,this has led to an insufficient understanding of HBO among many clinicians [7].In a survey of 200 medical students,175 either had only a rough understanding or had never heard of HBO medicine.The main problem was the lack of a proper understanding of the relationship between HBO medicine and clinical treatment.While patients’poor understanding of HBO is thought to be the most important factor affecting the development of HBO in China,the second most important factor is considered to be the low medical level [8].In our previous survey,however,HBO professionals believed that other related medical professionals’ poor understanding of HBO was the most important factor.For example,many medical professionals only understand HBO for the treatment of acute carbon monoxide poisoning.The uneven level of practitioners has also restricted the development of HBO [7].In view of the above reasons for clinicians’insufficient understanding of HBO,some scholars suggest that the 5-year clinical medicine major should offer HBO medicine courses and that practitioner training should be standardized[7].

Therefore,we launched the first HBO Medicine Week Publicity Campaign in 2016 to increase publicity.As indicated by the increase from 14 hospitals in the 4 provinces and municipalities directly under the central government in 2016 to 79 hospitals in 20 provinces,autonomous regions,and municipalities directly under the central government in 2018,our campaign has already created a brand effect[9].

However,there is still much room for improvement.Although free medical consultations and HBOT experiences were very popular in the previous three campaigns,there is a growing demand for more professional knowledge about HBO.It is difficult to unify training because of the wide distribution of the participating hospitals.For this reason,we utilized telemedicine lectures.

During the most recent campaign,other medical professionals actively participated in the interactions with our experts and asked many questions during the live broadcasts.This may help in the further development of HBO in local hospitals.

We have deepened our annual campaigns.Some participating hospitals have organized regular free clinics outside of publicity week.During our teleconference,more than 20 hospitals applied for credits of continuing education.Two hospitals included the lecture video in the continuing education system of their hospital.The clinical medical staff of the hospitals can learn through the network to strengthen their understanding and application of HBOT.

Conclusion

Our campaign have created a brand effect since beginning in 2016.In 2019,on the basis of the previous three campaigns,we explored different formats of publicizing HBO medicine in China,including telemedicine.