The prescription of domicilary long-term oxygen therapy in Auckland

(a) To assess the mode of referral and the demographic and clinical characteristics of patients prescribed oxygen between 1 January and 31 December 1994. (b) To assess whether international guidelines for prescribing oxygen were adhered to. (c) To assess the rate and pattern of prescription of oxygen in Auckland compared with other developed countries, and (d) based on these findings, to ascertain whether changes need to be made to our practise.

Notes of all patients referred to the oxygen service in 1994 were reviewed.

The oxygen service received 304 referrals in 1994 and 196 (including 23 infants), were commenced on long-term oxygen therapy. The primary diagnosis was chronic obstructive pulmonary disease (COPD) in 90 (52%), other chronic respiratory diseases 25 (14%) and terminal malignancy in 48(28%). Of the 173 adult patients prescribed oxygen 79% of patients were referred as a result of hospital admission. Thirty three percent of chronic obstructive pulmonary disease patients died within 6 months of receiving domiciliary oxygen which is higher than any previously published report. Mortality rates were no different between patients with chronic obstructive pulmonary disease and other respiratory disorders.

International guidelines for oxygen therapy were generally adhered to in Auckland though improvements could be made to ensure better quality information on referral and by use of blood gas analysis rather than oximetry. Fewer chronic obstructive pulmonary disease patients are receiving oxygen therapy in Auckland than expected and it is often prescribed late and as a result of hospital admission. Closer adherence to more recently published international guidelines and better targeting of patients with respiratory failure will impose a greater financial burden on the oxygen service, but may result in improved survival and reduced need of hospital admission. These findings have important resource implications, for oxygen services in New Zealand if they are to comply with International Guidelines for Domiciliary Oxygen Therapy.