Introduction Long-term oxygen therapy (LTOT) has been shown to improve survival in some patients with chronic obstructive pulmonary disease (COPD); generalisation to other groups of hypoxic patients is less clear. The British Thoracic Society recommend LTOT should be prescribed to hypoxic patients after appropriate assessment during a period of clinical stability.¹ In practise LTOT is frequently prescribed following hospitalisation. This form of oxygen therapy has been termed short-term oxygen therapy (STOT). We sought to audit our practise of prescribing home oxygen therapy to hypoxic patients following hospital admission with an exacerbation of a respiratory disorder.
Method We performed a retrospective case note audit of 30 patients [13 male] commenced on home oxygen therapy at discharge over a 6 month period recording patient demographics, smoking status, underlying diagnosis, compliance with BTS oxygen prescribing guidelines and the outcome of follow-up.
Results The mean age was 71 years (48–91yrs); 17% current smokers, 73% ex-smokers. COPD was the most common diagnosis in 80% (24/30); the mean FEV1 1.1L (52% predicted). No definitive diagnosis was documented in 10% (3/30) with 10% diagnosed with sarcoidosis, idiopathic pulmonary fibrosis or lung cancer. 64% (19/30) of patients met BTS LTOT criteria, (80% (19/24) with COPD), 33% (10/30) did not and 3% (1/30) were prescribed palliative oxygen. 93% of patients (27/29) were followed up at 3 months. The mean oxygen flow rate required was 1.4L/min; oxygen flow rate was altered in 63%. The overwhelming majority of our patients, 90% (26/29), continued with LTOT after reassessment at 3 months and 79% (23/29) at 6 months.
Conclusion Our audit shows that the majority of patients commenced on oxygen therapy post hospitalisation met the criteria for LTOT and continued to require oxygen at 3 and 6 months; this is a higher figure than quoted in the majority of the literature. This suggests our patients are presenting late with underlying chronic lung disease; we need to strive to identify these patients earlier. There is still a lack of evidence-based guidelines for STOT and further research in this area is needed.
BTS Home Oxygen Service in England and Wales. January 2006.
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