Fig. 27:  This Figure looks at the patient perspectives explaining why some COPD patients do not use portable oxygen assistance as prescribed.  When Arnold et al^[18] interviewed these patients, they commonly gave about a half-dozen reasons for why they do not use ambulatory oxygen.  One, which is rectifiable, was that they received no instructions on how to use it from their clinician or their provider of oxygen therapy.  They are unclear of what benefits the oxygen is supposed to give them.  They are afraid that if they take it out of the house it is going to run out during use, so why bring it?  Some are too embarrassed to be seen in public with oxygen therapy or afraid that it would mark them as being a frail person and would put them in harm’s way.  Some believe that the device is too heavy to carry to take it out in public and puts an undue load on their breathing, as well as their functional status; most feared that because they do not have a support person to help them all the time, this is a hindrance because getting around with the device, lugging it around when they are out of the house, imposes a burden on their ability to be more functional and prevents them doing what they need to do when they have to carry a large tank or even a more portable system overall.