Persons utilizing long term oxygen therapy (LTOT) at home suffer from chronic obstructive pulmonary disease (COPD). Adherence to LTOT ranges from 45% to 70% and utilization of 15 hours per day is widely accepted as efficacious. Although studies have reviewed the level of patient adherence with LTOT, few have introduced or evaluated interventions. The paucity of information regarding patients following oxygen prescription is an enormous void that must be tackled to augment clinical effectiveness and cost containment for the long term. A research agenda for LTOT adherence is postulated to help connect treatment adherence variables and concepts with clinical outcomes and quality of life.