Long-term domiciliary oxygen therapy - The Johannesburg Hospital experience

Objectives. To assess the clinical and demographic characteristics of patie nts attending an oxygen clinic, to assess the relevance of the current clin ical criteria determining the need for domiciliary oxygen, to assess the co st-effectiveness of an oxygen clinic and to assess compliance with the oxyg en prescription. Design. Descriptive study with a retrospective review of data. Setting. Tertiary-level academic hospital. Subjects. All patients attending a newly established oxygen clinic. Results. Data were analysed for 679 patients (361 male and 318 female), of whom 543 were ex- or current smokers, and 136 were non-smokers. Of the tota l number, 576 had chronic obstructive pulmonary disease. Oxygen was given t o 425 patients and denied to 254. Forced expiratory volume in 1 second (FEV 1) is probably not of value in determining requirement for oxygen as there was no correlation between severity of lung disease and partial arterial ox ygen pressure (PaO2). There was also no correlation between PaO2 and litres of oxygen prescribed. Compliance with the oxygen prescription was 39%. Cos t savings to the State from the oxygen that was not prescribed was in the r egion of R125 000 per month. Conclusions. Each patient should be assessed individually using clinical pa rameters to classify the disease severity and to assess the degree of tissu e hypoxia. Oxygen clinics are of value and should be established more widel y within each province. Compliance is suboptinial and continued followup to motivate patients to use the oxygen as prescribed should be instituted.