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Oxygen Treatment - New guidelines for use inside and outside the home

July 23, 1999

Oxygen therapy has long been recognised as helping some patients with COPD live longer, and it is estimated that around 18,000 patients benefit from the treatment each year in the UK.

Oxygen treatment is also currently used to help patients with other conditions such as cystic fibrosis, interstitial lung disease, neuromuscular/skeletal disorders, chronic heart failure and in palliative care for cancer patients. It is estimated that some 30-50% more patients who could benefit are not currently being prescribed the treatment.




Although the benefits of the therapy are known, previous studies on the prescription of oxygen concentrators had shown variability in prescribing habits, poor adherence to present guidelines and lack of any organised follow-up and monitoring arrangements.

The Department of Health asked the College to produce new guidelines to tackle these problems, reviewing the current provision of domiciliary oxygen and making evidence-based recommendations on which patients should be prescribed oxygen therapy and under what circumstances. The report suggests that the Department of Health undertakes a pilot study of the usefulness of the assessment forms supplied as an appendix to the report.

The multi-disciplinary group which produced the report made recommendations in relation to assessment and prescription of long-term oxygen therapy, ambulatory (outside the home or when travelling) oxygen therapy, short-burst oxygen therapy and the organisation of home oxygen services. The report also provides recommendations for oxygen therapy in infants and children, including children who need oxygen at school.

The report gives comprehensive and useful guidance to doctors, nurses, other health professionals, providers and purchasers of healthcare on the assessment and provision of oxygen treatment, and for patients there is useful information on the use of oxygen at home and when travelling. The report sets out:

exactly which patients can benefit from the therapy
the differences between adults and children in prescribing oxygen therapy
what suitable equipment can be prescribed
where further trials and research are needed
what information should be given to patients about their treatment - this is crucial as roughly half of patients receiving the therapy are housebound and cannot visit the GP or hospital
what safety measures are needed when oxygen equipment is supplied in the home
what education is needed for health professionals about oxygen therapy
practical considerations for patients when travelling, and which organisations can advise patients further

Dr Wisia Wedzicha, Secretary of the Working Party, said:
"This report is designed to ensure that home oxygen therapy is prescribed for patients who can benefit with appropriate monitoring conditions, so that we can improve quality of life for patients with disabling diseases."


Royal College of Physicians



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