IMPROVEMENT IN PATIENT COMPLIANCE WITH LONG-TERM OXYGEN-THERAPY FOLLOWING FORMAL ASSESSMENT WITH TRAINING

In the Department of Respiratory Medicine, North Staffordshire Hospita l, patients fulfilling the Department of Health criteria for long-term oxygen therapy (LTOT) attend a practical teaching session on the use of their oxygen concentrator before commencing therapy. In the present study, we have audited the prescribing of LTOT in all patients in thr ee health districts in the North West Midlands reviewed between June 1 992 and July 1994. They were split into two groups. The first had the assessment and training programme in the department. Patients in the c ontrol group had been prescribed LTOT from outside the department with out any formal training. In both groups of patients information was co llated 6 months after starting LTOT by means of a questionnaire assess ing patients', understanding of both their need for oxygen and their d isease process, the dangers of oxygen therapy and present smoking habi t. Objective information about the usage of each concentrator was obta ined from engineer reports. Thirty-six patients (eight from the traine d group and 28 controls) died before evaluation at 6 months. Forty-fiv e patients (29 male, mean age 71 years) received training and 41 contr ol patients (24 male, mean age 72 years) were evaluated. Thirty-seven (82%) patients who had received formal training were using their conce ntrator for greater than 15 h compared with only 18 (44%) of the contr ols (P=0.0002). Forty-two (93%) patients who had received training und erstood why they were using LTOT compared with only 17 (41%) in the co ntrol group (P=0.00001). Although both groups had a similar understand ing of the dangers of smoking while on oxygen therapy, six (15%) of th e control group were smoking as compared to only one (2%) of the train ed group (P=0.038). One of the control patients had received significa nt facial burns as a direct result of smoking while on oxygen. Further efforts are required to ensure that all patients prescribed LTOT shou ld have a formal respiratory assessment as well as training to improve compliance and to obtain maximal benefits from such therapy.