PURPOSE:1. To evaluate the variations of LTOT/HLTV in the time, and 2.LTOT prescription appropriateness before and after some educational and organizational actions.
METHODS:Socio-demographic, and clinical information, the appropriateness and prescription data about patients receiving LTOT/HLTV in the Ferrara area (North Italy) were charged in a “ad hoc clinical data base” in the period 2002-march2008. For aim 1 we calculated the incidence rates standardized by age, in male and female (Ferrara census 2001), and the actual prevalence rough rates (Ferrara last census 2005). Stated actions for aim 2 were: a. Disseminating ERS guidelines criteria for LTOT prescription and standard prescription models (January 2007) b. Regular clinical monitoring of all patients receiving LTOT/HLTV.
RESULTS:1053 patients (65% male, mean age 72 yrs male and 88 yrs female) were prescribed (72% LTOT e 36% HLTV). Actual respiratory devices in use are 533 (1.5ë residents, 2.2 male and 0.9 female), 38.3% LTOT only, 52.5% HLTV only, 9.2% both. The incidence rate shows an upward trend more evident in males, (4.93/10.000 residents in the year 2002 and 7.27 in 2006) than in females (1.72 and 2.25) and seems to have reached a steady state. The number of withdrawals due to “non indication” were 6.3% in 2007, and 4.6% in the before years. Among those patients who assumed LTOT >16 hrs/day in 2007, 64% (n=175) received an appropriate prescription, and the appropriateness was significantly better in 2007 (86%) than in before years (60% average). LTOT was suspended in 11% of patients 2007 vs 6.5% of patients average in before years.
CONCLUSION:The study shows the efficacy of a clinical monitoring in LTOT patients and of the implementation with an educational program to reach a better appropriateness of LTOT prescriptions.
CLINICAL IMPLICATIONS:Clinical monitoring is a crucial method to control compliance of LTOT, to avoid non appropriate prescriptions and to save health resources.
DISCLOSURE:Alfredo Potena, FCCP, No Financial Disclosure Information; No Product/Research Disclosure Information