Prescription and usage of long-term oxygen therapy in patients with chronic obstructive pulmonary disease in the Netherlands

Long-term oxygen therapy (LTOT) has been shown to improve survival in hypox aemic patients with chronic obstructive pulmonary disease (COPD). This has resulted in recommending the prescription of oxygen for at least 15 h day(- 1) in most European countries. In order to examine the prescription and usage of LTOT and to assess the ad herence to international recommendations for its prescription, a survey was set up in a random sample of clients of the largest oxygen company in the Netherlands. After patients had been visited for an interview, additional p ostal surveys were sent to the physician who had prescribed LTOT and to the oxygen company. For 175 COPD patients the mean oxygen prescription and mean oxygen usage we re 15.6 +/- 5.8 and 14.1 +/- 6.8 h day(-1) respectively. In 62 patients (35 % oxygen was prescribed <15 h day(-1), more often by non-chest physicians t han by chest physicians (P<0.0001), and 91 patients (52%) used oxygen <15 h day(-1). Of 113 patients with a prescription greater than or equal to 15 h day(-1) , 39 (35%) used oxygen <15 h day(-1) and 74 for greater than or eq ual to 15 h day(-1). The latter were prescribed oxygen for mon h day(-1). h ad been longer on LTOT, had a higher resting flow rate, were prescribed a c oncentrator, employed portable cylinders and used oxygen in public signific antly more often than the former. We conclude that in a selected group of LTOT patients with COPD both oxygen prescription and usage were often inadequate, particularly if LTOT was pre scribed by non-chest physicians.