Skip to main content
Thorax logoLink to Thorax
. 1995 Oct;50(10):1103–1105. doi: 10.1136/thx.50.10.1103

Review of the prescription of domiciliary long term oxygen therapy in Scotland.

D Morrison 1, K Skwarski 1, W MacNee 1
PMCID: PMC475027  PMID: 7491562

Abstract

BACKGROUND--Since 1989 long term oxygen therapy (LTOT) in Scotland has been prescribable only by respiratory physicians, whereas in England and Wales general practitioners can also prescribe this treatment. The effect of this policy has been audited. METHOD--Six hundred and thirty patients were prescribed LTOT in Scotland between 1 October 1989 and 30 September 1991, of which 519 case notes were reviewed. RESULTS--In 79% of patients the diagnosis was chronic obstructive pulmonary disease (COPD), with a near equal male to female ratio. The mean (SD) age was 65 (13) years (range 0.2-90). Sixty percent of patients died during the study period. Compliance with treatment was 14.9 (6.0) hours daily (range 1-24) and in 44% was less than 15 hours daily. Sixty one percent were clinically unstable when assessed and 14% were still smoking. Only 14% of those with COPD fulfilled all of the relative criteria for the prescription of LTOT. Only 56% had a repeated arterial blood gas measurement within 12 months of prescription and 51% of these were taken during a period of clinical instability. Expenditure on oxygen cylinders was six times greater than on oxygen concentrators over this period. CONCLUSIONS--Compliance with LTOT in Scotland, where prescription is the responsibility of respiratory physicians, is similar to other studies and ranges widely. The greatest problem concerning adherence to the guidelines is assessment during clinical instability. The number of deaths suggest that prescription occurs late in the course of the disease. This study highlights the areas where the prescription of LTOT needs to be improved.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Levi-Valensi P., Weitzenblum E., Pedinielli J. L., Racineux J. L., Duwoos H. Three-month follow-up of arterial blood gas determinations in candidates for long-term oxygen therapy. A multicentric study. Am Rev Respir Dis. 1986 Apr;133(4):547–551. doi: 10.1164/arrd.1986.133.4.547. [DOI] [PubMed] [Google Scholar]
  2. Restrick L. J., Paul E. A., Braid G. M., Cullinan P., Moore-Gillon J., Wedzicha J. A. Assessment and follow up of patients prescribed long term oxygen treatment. Thorax. 1993 Jul;48(7):708–713. doi: 10.1136/thx.48.7.708. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Walshaw M. J., Lim R., Evans C. C., Hind C. R. Factors influencing the compliance of patients using oxygen concentrators for long-term home oxygen therapy. Respir Med. 1990 Jul;84(4):331–333. doi: 10.1016/s0954-6111(08)80062-5. [DOI] [PubMed] [Google Scholar]
  4. Walters M. I., Edwards P. R., Waterhouse J. C., Howard P. Long term domiciliary oxygen therapy in chronic obstructive pulmonary disease. Thorax. 1993 Nov;48(11):1170–1177. doi: 10.1136/thx.48.11.1170. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES