The Impact of Long Term Oxygen Therapy on South Australian Patients with Chronic Lung Disease

The peer-reviewed publications contained within this thesis describe studies that have contributed significantly to the understanding of long-term oxygen therapy (LTOT) for Australian Chronic Obstructive Pulmonary Disease (COPD) patients. My personal contribution to each of these studies ranged from the initial development of the hypotheses and design and execution of the investigations, submission of research grants applications to fund the studies through to preparation of the manuscripts for publication. When LTOT was first introduced into Australia I was fortunate to meet the key experts in LTOT including Professors Tom Petty, Nick Anthonisen, David Flenley, Pierre Levi-Valensi and Peter Howard. At that time all were involved in randomised controlled trials of oxygen therapy. (1, 2), 3). I also visited several oxygen concentrator and oxygen supply companies in the USA and UK. It was during these visits that I became convinced that the concentrator provided a more economical and efficient method of LTOT delivery. In 1980, an oxygen concentrator was imported to Australia by the spouse of one of our patients suffering from emphysema who was receiving long term oxygen via cylinders In 1982, two oxygen concentrators were donated to FMC by two different manufacturers (DeVilbis and Marx) based in the USA. These instruments were trialled on a male and female patient receiving LTOT in the Southern Adelaide metropolitan area. The initial acceptance of this device by these patients led to a submission to the South Australian Department of Health for a grant to purchase 40 units. Funds were finally obtained for the purchase of 34 concentrators by FMC and these were rolled out to the then existing patients who were receiving LTOT in 1984. Up to this point in time the only published guidelines or recommendations for LTOT came from the American College of Chest Physicians in 1973(3) and the American Thoracic Society in