THE PRESCRIPTION OF DOMICILARY LONG-TERM OXYGEN-THERAPY IN AUCKLAND

Aims. (a) To assess the mode of referral and the demographic and clini cal characteristics of patients prescribed oxygen between 1 January an d 31 December 1994. (b) To assess whether international guidelines for prescribing oxygen were adhered to. (c) To assess the rate and patter n of prescription of oxygen in Auckland compared with other developed countries, and (d) based on these findings, to ascertain whether chang es need to be made to our practise. Method. Notes of all patients refe rred to the oxygen service in 1994 were reviewed. Results. The oxygen service received 304 referrals in 1994 and 196 (including 23 infants), were commenced on long term oxygen therapy. The primary diagnosis was chronic obstructive pulmonary disease (COPD) in 90 (52%), other chron ic respiratory diseases 25 (14%) and terminal malignancy in 48 (28%). Of the 173 adult patients prescribed oxygen 79% of patients were refer red as a result of hospital admission. Thirty three percent of chronic obstructive pulmonary disease patients died within 6 months of receiv ing domiciliary oxygen which is higher than any previously published r eport. Mortality rates were no different between patients with chronic obstructive pulmonary disease and other respiratory disorders. Conclu sions. International guidelines for oxygen therapy were generally adhe red to in Auckland though improvements could be made to ensure better quality information on referral and by use of blood gas analysis rathe r than oximetry. Fewer chronic obstructive pulmonary disease patients are receiving oxygen therapy in Auckland than expected and it is often prescribed late and as a result of hospital admission. Closer adheren ce to more recently published international guidelines and better targ eting of patients with respiratory failure will impose a greater finan cial burden on the oxygen service, but may result in improved survival and reduced need of hospital admission. These findings have important resource implications, for oxygen services in New Zealand if they are to comply with International Guidelines for Domiciliary Oxygen Therap y.