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Optimising the therapeutic use of oxygen in Australia

Christine F McDonald and Alan J Crockett
Med J Aust 2009; 191 (10): . || doi: 10.5694/j.1326-5377.2009.tb03302.x
Published online: 16 November 2009

We need a national register of home oxygen therapy

Oxygen has been used for therapeutic purposes for centuries, but until relatively recently no scientifically rigorous trials had confirmed its true benefits. In the early 1980s, two landmark randomised trials — the Medical Research Council (MRC) trial and the Nocturnal Oxygen Therapy Trial (NOTT) — showed that continuous or semi-continuous oxygen therapy for between 15 and 24 hours a day provided a mortality benefit in patients with chronic obstructive pulmonary disease (COPD) and severe hypoxaemia.1,2 Survival rates for those prescribed “continuous” oxygen (in reality about 19 hours per day) in the NOTT were around 80% at 2 years, compared with around 60% for the “nocturnal” group using oxygen for only 12 hours per day. In the MRC study, in which patients were randomly allocated to receive oxygen for 15 hours per day versus no oxygen, survival rates at 5 years were 67% versus 45%, respectively.


  • 1 Department of Respiratory and Sleep Medicine, Austin Hospital, Melbourne, VIC.
  • 2 Primary Care Respiratory Research Unit, University of Adelaide, Adelaide, SA.



  • 1. Nocturnal Oxygen Therapy Trial Group. Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Ann Intern Med 1980; 93: 391-398.
  • 2. Medical Research Council Working Party. Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. Lancet 1981; 1: 681-686.
  • 3. McDonald CF, Crockett A, Young I. Adult domiciliary oxygen therapy. Position statement of the Thoracic Society of Australia and New Zealand. Med J Aust 2005; 182: 621-626. <MJA full text>
  • 4. Croxton TL, Bailey WC. Long-term oxygen treatment in chronic obstructive pulmonary disease: recommendations for future research: an NHLBI research workshop report. Am J Respir Crit Care Med 2006; 174: 373-378.
  • 5. Cranston JM, Nguyen AM, Crockett AJ. The relative survival of COPD patients on long-term oxygen therapy in Australia: A comparative study. Respirology 2004; 9: 237-242.
  • 6. Buist AS, McBurnie MA, Vollmer WM, et al. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet 2007; 370: 741-750.
  • 7. Earnest MA. Explaining adherence to supplemental oxygen therapy: the patient’s perspective. J Gen Intern Med 2002; 17: 749-755.
  • 8. Ludot A, d’Orbcastel OR. Home respiratory care. Therapie 2001; 56: 143-149.
  • 9. Serginson JG, Yang IA, Armstrong JG, et al. Variability in the rate of prescription and cost of domiciliary oxygen therapy in Australia. Med J Aust 2009; 191: 549-553. <eMJA full text>
  • 10. National Health and Hospitals Reform Commission. A healthier future for all Australians: final report June 2009. http://www.nhhrc.org.au/internet/nhhrc/publishing.nsf/Content/nhhrc-report (accessed Sep 2009).
  • 11. The Australian Lung Foundation. Chronic obstructive pulmonary disease. Knocking the wind out of over one million Australians. A national approach to COPD. Funding submission, 2006. http://www.lungfoundation.com.au/images/stories/docs/2006_n_budget_sub_final_alf.pdf (accessed Sep 2009).

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