Utilidad de la visita a domicilio en el control y valoración del uso apropiado de la oxigenoterapia continua domiciliaria

Abstract

The aim of this study was to determine the usefulness of home visits to monitor and evaluate the appropriate use of domiciliary oxygen therapy (DOT). Appropriateness was based on the coincidence of circumstances needed to predict benefit from DOT: appropriate indications correct hypoxemia and patient compliance. All patients receiving DOT residing in the town of L'Hospitalet (Barcelona) in June 1994 were enrolled. During a home visit to each patient a questionnaire was administered and spirometric variables, CO in exhaled air and pulse oximetry were recorded. If DOT was not considered appropriate, the patient was referred to the hospital clinic for reevaluation of the prescription. One hundred twenty-eight patients (74% men) were visited. Mean age was 68 years. Use of DOT was seen to be appropriate in only 26% of patients. The prescription of DOT was considered strictly correct in 73 patients (49%); 13 of them were seen to have continued smoking. Of the 60 remaining patients, hypoxemia was correct with oxygen therapy in 46, and of these only 33 complied with DOT. The home visit combined with hospital monitoring allowed us to withdraw DOT from 20 patients, for whom the indications had been incorrect, and to introduce changes in oxygen supply sources for 16 patients who carried pumps. Fourteen started using a concentrator and 2 began using liquid oxygen. Periodic review is necessary for optimal treatment of DOT. The home visit is a good tool for improving DOT follow-up, as it allows the patient to be assessed in the setting where DOT is really applied. It is a monitoring method that is well accepted by the patient.