ASSESSMENT AND FOLLOW-UP OF PATIENTS PRESCRIBED LONG-TERM OXYGEN TREATMENT

Background-Prescription and use of long term oxygen treatment were aud ited in a large group of patients after more than five years of use of the guidelines for its prescription. Methods-Patients with a concentr ator were interviewed at home with a structured questionnaire in three family health service authorities in East London. Stable oxygen satur ation (SaO2) breathing air and oxygen, forced expiratory volume in one second (FEV1) and current and previous dated concentrator meter readi ngs were recorded. A further questionnaire was sent to each patient's general practitioner. Hospital case notes of patients who did not meet the criteria for long term oxygen treatment at reassessment were revi ewed. Results-A total of 176 patients were studied; 84% had chronic ob structive lung disease and 19% admitted to continued smoking; 140 pati ents had seen a respiratory physician but results of respiratory asses sment were available to their general practioner in fewer than 54 case s. FEV1 was <1.5 1 in 158 patients but in 67 SaO2 was less than 91% br eathing air, mainly in patients with chronic obstructive lung disease who had been inadequately assessed. Daily oxygen was prescribed for a median of 15 (range 4-24) hours and measured daily use was 15 (0-24) h ours; 74% of patients used more than 12 hours. Only 35 patients had pr oblems with oxygen treatment, but 29 had an undercorrected SaO2 of les s than 92% when using their concentrator. Conclusions-Guidelines for p rescription of long term oxygen treatment are largely followed and mos t patients complied with treatment. Increased communication about resp iratory state is required between hospital doctors and general practit ioners. Patients need regular reassessments to ensure that hypoxaemia is corrected and that oxygen is appropriately prescribed.