Long-term domiciliary oxygen therapy – the Johannesburg hospital experience
Objectives. To assess the clinical and demographic characteristics of patients attending an oxygen clinic, to assess the relevance of the current clinical criteria determining the need for domiciliary oxygen, to assess the cost-effectiveness of an oxygen clinic and to assess compliance with the oxygen 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 total number, 576 had Chronic obstructive pulmonary disease. Oxygen was given to 425 patients and denied to 254. Forced expiratory volume in 1 second (FEV,) is probably not of value in determining requirement for oxygen as there was no correlation between . severity of lung disease and partial arterial oxygen pressure (Pa02). There was also no correlation between Pa02 and litres of oxygen prescribed. Compliance with the oxygen prescription was 39%. Cost savings to the State from the oxygen that was not prescribed was in the region of R125 000 per month.
Conclusions. Each patient should be assessed individually using clinical parameters to classify the disease severity and to assess the degree of tissue hypoxia. Oxygen clinics are of value and should be. established more widely within each province. Compliance is suboptimal and continued followup to motivate patients to use the oxygen as prescribed should be instituted.