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Prescribing practice for intermittent oxygen therapy: a GP survey
B O'Neill1, J M Bradley, A M McKevitt
1School of Rehabilitation Sciences, University of Ulster and Regional Respiratory Centre, Belfast City Hospital, Belfast, UK.
Chronic Respiratory Disease
|November 12, 2005
Summary
Most general practitioners prescribe home oxygen for chronic obstructive pulmonary disease (COPD) without objective assessment, relying on specialist advice. Implementing evidence-based guidelines can rationalize oxygen therapy use.
Area of Science:
- Respiratory Medicine
- General Practice
- Health Services Research
Background:
- Substantial prescription rates for home oxygen cylinders for intermittent use are observed in the UK.
- Intermittent oxygen therapy is a significant treatment modality for patients with chronic obstructive pulmonary disease (COPD).
Purpose of the Study:
- To investigate the assessment criteria and prescribing practices of general practitioners (GPs) for intermittent oxygen therapy in COPD patients in Northern Ireland.
- To evaluate the current approach to prescribing intermittent oxygen therapy in primary care.
Main Methods:
- A postal questionnaire survey was distributed to 534 GPs in two Northern Ireland health boards who had prescribed cylinder oxygen within six months prior to the study.
- The questionnaire underwent piloting to ensure reliability and validity of the data collected.
Main Results:
- A 52% response rate (280/534 GPs) was achieved.
- The majority of GPs (82%) relied on advice from hospital specialists to determine the need for intermittent oxygen.
- Objective assessment methods like breathlessness scores (e.g., BORG), exercise oximetry, and adherence to local or national guidelines were infrequently or never utilized.
Conclusions:
- A significant proportion of intermittent oxygen prescriptions for COPD patients may lack objective assessment.
- There is a need for the implementation of evidence-based guidelines for oxygen therapy assessment.
- Establishing a formal oxygen assessment service could rationalize the use of this costly resource and improve patient targeting.