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Prevalence of respiratory support in the community – the Surrey experience

Introduction

This study aimed to establish the prevalence of home ventilatory and respiratory support within the catchment area of Frimley Park Hospital in Surrey. The number of patients receiving respiratory support at home has been increasing nationally since 1990 [1]; however, no local data exist. This trend is likely to continue as domiciliary ventilation gains popularity for the treatment of obstructive sleep apnoea and certain groups of COPD patients [2].

Method

A postal survey was sent out to practice managers in the local catchment area. They were asked to provide data for: patients on home ventilatory support for any reason, patients with long-term tracheostomies, patients with COPD who are on home oxygen or who you would classify as end stage, and the total number of patients registered to the practice. This was followed up with a telephone call approximately 2 weeks later. Many were then emailed the same questionnaire. A further two telephone calls to each practice were made as necessary in order to obtain data.

Results

Out of 67 surgeries contacted, we achieved a response rate of 65%. Thirty-three practices (49%) were able to provide complete data, six (9%) provided partial data, and a further five (7%) were unable or unwilling to provide any data. Twenty-three (34%) practices did not respond. A total of 318,130 patients were listed by the responding practices. Of these: 23 patients live with long-term tracheostomies, a prevalence of 1 in 13,800; 65 patients receive mechanical respiratory support at home, a prevalence of 1 in 4,900; and 207 patients receive oxygen therapy at home, a prevalence of 1 in 1,500.

Discussion

This study suggests that the Frimley Park Hospital population of 350,000 currently contains about 100 individuals requiring mechanical respiratory support at home. This is of concern as currently there is no formal support for any of these high-risk patients other than ventilator maintenance. Simple problems precipitate hospital admission and rapidly trigger outreach or intensive care review. The current position is clearly unsatisfactory and must be addressed by PCTs if patient numbers increase.

References

  1. 1.

    Simonds A: Eur Respir J. 2003, 38s-46s. 10.1183/09031936.03.00029803. Suppl 47

  2. 2.

    Consensus conference report. Chest. 1999, 116: 521-534. 10.1378/chest.116.2.521.

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Burfield, S., Sherrard-Smith, L., Laitt, E. et al. Prevalence of respiratory support in the community – the Surrey experience. Crit Care 11, P162 (2007). https://0-doi-org.brum.beds.ac.uk/10.1186/cc5322

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Keywords

  • Catchment Area
  • Telephone Call
  • Ventilatory Support
  • Oxygen Therapy
  • Obstructive Sleep Apnoea