0640 Initial Sleep Center Evaluation and Follow Up Improves Positive Airway Pressure (PAP) Therapy Adherence When Compared to Direct Referrals Without Sleep Physician Follow Up: A Retrospective Study
Abstract Introduction Obstructive sleep apnea (OSA) affects 26% of adults and positive airway pressure (PAP) is the gold-standard of therapy. Factors affecting PAP adherence—use >4 hours in a 24-hour period—have been studied extensively. We compared of the three months (or other time frame) PAP a...
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| Veröffentlicht in: | Sleep (New York, N.Y.) N.Y.), 2020-05, Vol.43 (Supplement_1), p.A244-A245 |
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| creator | Aljarod, T Tran, L Al Ikhwan, M Prasad, B |
| description | Abstract
Introduction
Obstructive sleep apnea (OSA) affects 26% of adults and positive airway pressure (PAP) is the gold-standard of therapy. Factors affecting PAP adherence—use >4 hours in a 24-hour period—have been studied extensively. We compared of the three months (or other time frame) PAP adherence between patients seen by a sleep specialist prior to OSA diagnosis versus patients referred directly for OSA testing by non-sleep specialist providers. The goal of the study was to understand the impact of sleep consultation on PAP adherence.
Methods
Direct referral (DR) patients underwent polysomnography (PSG) and received PAP devices prior to the sleep clinic visit. In contrast, sleep center patients (SC) had a sleep clinic visit with a sleep physician or APRN prior to PSG.
Eighty-four patients were included in this study, 42 DR and 42 SC patients. Exclusion criteria were age |
| doi_str_mv | 10.1093/sleep/zsaa056.636 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2502906931</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/sleep/zsaa056.636</oup_id><sourcerecordid>2502906931</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1506-cbcb26d594bbbb77ed4d6b166b927d0c3bd64a4ec8f17d5d015b71dc6c7c64b53</originalsourceid><addsrcrecordid>eNqNkd9q2zAUxkXZoFnXB-jdgd5sMDdSbMnx7kyadoHCTP_QSyNLJ0TFsTxJTvBesK81ZQnsdro5Euf7ne-gj5ArRm8YLdKpbxH76W8vJeXiRqTijEwY5zQpYvsDmVAmWDJnlJ-TT96_0fjOinRC3qnIKKw6E4xs4ekwBRbYBXSw3Ml2kMHYDmSn4c62rd3DSw-rbe_sDj1U1kduh1Aat5cjVA69HxzCl6qsvsLzBp3sRyh1vGCnEF432MHCbnvpUEOwcGscqgCPuEbnZOvh1YSNHcJpk2ozeqOM7P65f4cyyoOzvo_kwfwpDHr8TD6uI4-Xp3pBXu6Wz4sfycPP-9WifEgU41QkqlHNTGheZE08eY4606JhQjTFLNdUpY0WmcxQzdcs11xTxpucaSVUrkTW8PSCXB_nxi_4NaAP9ZsdXBct6xmns4KKImVRxY4qFff0Dtd178xWurFmtD7kVf_Nqz7lVce8IvPtyNih_w_5H4t-nU8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2502906931</pqid></control><display><type>article</type><title>0640 Initial Sleep Center Evaluation and Follow Up Improves Positive Airway Pressure (PAP) Therapy Adherence When Compared to Direct Referrals Without Sleep Physician Follow Up: A Retrospective Study</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Aljarod, T ; Tran, L ; Al Ikhwan, M ; Prasad, B</creator><creatorcontrib>Aljarod, T ; Tran, L ; Al Ikhwan, M ; Prasad, B</creatorcontrib><description>Abstract
Introduction
Obstructive sleep apnea (OSA) affects 26% of adults and positive airway pressure (PAP) is the gold-standard of therapy. Factors affecting PAP adherence—use >4 hours in a 24-hour period—have been studied extensively. We compared of the three months (or other time frame) PAP adherence between patients seen by a sleep specialist prior to OSA diagnosis versus patients referred directly for OSA testing by non-sleep specialist providers. The goal of the study was to understand the impact of sleep consultation on PAP adherence.
Methods
Direct referral (DR) patients underwent polysomnography (PSG) and received PAP devices prior to the sleep clinic visit. In contrast, sleep center patients (SC) had a sleep clinic visit with a sleep physician or APRN prior to PSG.
Eighty-four patients were included in this study, 42 DR and 42 SC patients. Exclusion criteria were age <18 years old, absence of baseline PSG, and lack of 90-day compliance data. Covariates included demographics, body mass index (BMI), AHI, nadir oxygen saturation, demographics, and Epworth Sleepiness Scale (ESS) score. Objective PAP adherence for first 90 days was the primary outcome.
Results
Age (p=0.1), ESS (p=0.3), BMI (p=0.6), and AHI (p=0.9) were not significantly different between the groups. SC patients had greater PAP adherence (4.77 hours, 95%CI: 4.1 to 5.4) compared to DR patients (3.61 hours, 95%CI: 2.88 to 4.33, p=0.02). SC patients were also 8 times more likely to follow up in clinic within 1 year of starting PAP treatment (Likelihood Ratio 8.25, p=0.004).
Conclusion
While possibly more time-efficient for patients, direct referrals may ultimately result in lower PAP adherence due to missed opportunities for receiving education about OSA and PAP therapy. This is consistent with findings from a previous meta-analysis demonstrating that educational interventions improve PAP adherence. Moving forward, we will continue encouraging directly referred patients to follow up in the sleep center after PSG.
Support
None</description><identifier>ISSN: 0161-8105</identifier><identifier>EISSN: 1550-9109</identifier><identifier>DOI: 10.1093/sleep/zsaa056.636</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Medical referrals ; Sleep apnea ; Systematic review</subject><ispartof>Sleep (New York, N.Y.), 2020-05, Vol.43 (Supplement_1), p.A244-A245</ispartof><rights>Sleep Research Society 2020. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com. 2020</rights><rights>Sleep Research Society 2020. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids></links><search><creatorcontrib>Aljarod, T</creatorcontrib><creatorcontrib>Tran, L</creatorcontrib><creatorcontrib>Al Ikhwan, M</creatorcontrib><creatorcontrib>Prasad, B</creatorcontrib><title>0640 Initial Sleep Center Evaluation and Follow Up Improves Positive Airway Pressure (PAP) Therapy Adherence When Compared to Direct Referrals Without Sleep Physician Follow Up: A Retrospective Study</title><title>Sleep (New York, N.Y.)</title><description>Abstract
Introduction
Obstructive sleep apnea (OSA) affects 26% of adults and positive airway pressure (PAP) is the gold-standard of therapy. Factors affecting PAP adherence—use >4 hours in a 24-hour period—have been studied extensively. We compared of the three months (or other time frame) PAP adherence between patients seen by a sleep specialist prior to OSA diagnosis versus patients referred directly for OSA testing by non-sleep specialist providers. The goal of the study was to understand the impact of sleep consultation on PAP adherence.
Methods
Direct referral (DR) patients underwent polysomnography (PSG) and received PAP devices prior to the sleep clinic visit. In contrast, sleep center patients (SC) had a sleep clinic visit with a sleep physician or APRN prior to PSG.
Eighty-four patients were included in this study, 42 DR and 42 SC patients. Exclusion criteria were age <18 years old, absence of baseline PSG, and lack of 90-day compliance data. Covariates included demographics, body mass index (BMI), AHI, nadir oxygen saturation, demographics, and Epworth Sleepiness Scale (ESS) score. Objective PAP adherence for first 90 days was the primary outcome.
Results
Age (p=0.1), ESS (p=0.3), BMI (p=0.6), and AHI (p=0.9) were not significantly different between the groups. SC patients had greater PAP adherence (4.77 hours, 95%CI: 4.1 to 5.4) compared to DR patients (3.61 hours, 95%CI: 2.88 to 4.33, p=0.02). SC patients were also 8 times more likely to follow up in clinic within 1 year of starting PAP treatment (Likelihood Ratio 8.25, p=0.004).
Conclusion
While possibly more time-efficient for patients, direct referrals may ultimately result in lower PAP adherence due to missed opportunities for receiving education about OSA and PAP therapy. This is consistent with findings from a previous meta-analysis demonstrating that educational interventions improve PAP adherence. Moving forward, we will continue encouraging directly referred patients to follow up in the sleep center after PSG.
Support
None</description><subject>Medical referrals</subject><subject>Sleep apnea</subject><subject>Systematic review</subject><issn>0161-8105</issn><issn>1550-9109</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkd9q2zAUxkXZoFnXB-jdgd5sMDdSbMnx7kyadoHCTP_QSyNLJ0TFsTxJTvBesK81ZQnsdro5Euf7ne-gj5ArRm8YLdKpbxH76W8vJeXiRqTijEwY5zQpYvsDmVAmWDJnlJ-TT96_0fjOinRC3qnIKKw6E4xs4ekwBRbYBXSw3Ml2kMHYDmSn4c62rd3DSw-rbe_sDj1U1kduh1Aat5cjVA69HxzCl6qsvsLzBp3sRyh1vGCnEF432MHCbnvpUEOwcGscqgCPuEbnZOvh1YSNHcJpk2ozeqOM7P65f4cyyoOzvo_kwfwpDHr8TD6uI4-Xp3pBXu6Wz4sfycPP-9WifEgU41QkqlHNTGheZE08eY4606JhQjTFLNdUpY0WmcxQzdcs11xTxpucaSVUrkTW8PSCXB_nxi_4NaAP9ZsdXBct6xmns4KKImVRxY4qFff0Dtd178xWurFmtD7kVf_Nqz7lVce8IvPtyNih_w_5H4t-nU8</recordid><startdate>20200527</startdate><enddate>20200527</enddate><creator>Aljarod, T</creator><creator>Tran, L</creator><creator>Al Ikhwan, M</creator><creator>Prasad, B</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope></search><sort><creationdate>20200527</creationdate><title>0640 Initial Sleep Center Evaluation and Follow Up Improves Positive Airway Pressure (PAP) Therapy Adherence When Compared to Direct Referrals Without Sleep Physician Follow Up: A Retrospective Study</title><author>Aljarod, T ; Tran, L ; Al Ikhwan, M ; Prasad, B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1506-cbcb26d594bbbb77ed4d6b166b927d0c3bd64a4ec8f17d5d015b71dc6c7c64b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Medical referrals</topic><topic>Sleep apnea</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aljarod, T</creatorcontrib><creatorcontrib>Tran, L</creatorcontrib><creatorcontrib>Al Ikhwan, M</creatorcontrib><creatorcontrib>Prasad, B</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><jtitle>Sleep (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aljarod, T</au><au>Tran, L</au><au>Al Ikhwan, M</au><au>Prasad, B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>0640 Initial Sleep Center Evaluation and Follow Up Improves Positive Airway Pressure (PAP) Therapy Adherence When Compared to Direct Referrals Without Sleep Physician Follow Up: A Retrospective Study</atitle><jtitle>Sleep (New York, N.Y.)</jtitle><date>2020-05-27</date><risdate>2020</risdate><volume>43</volume><issue>Supplement_1</issue><spage>A244</spage><epage>A245</epage><pages>A244-A245</pages><issn>0161-8105</issn><eissn>1550-9109</eissn><abstract>Abstract
Introduction
Obstructive sleep apnea (OSA) affects 26% of adults and positive airway pressure (PAP) is the gold-standard of therapy. Factors affecting PAP adherence—use >4 hours in a 24-hour period—have been studied extensively. We compared of the three months (or other time frame) PAP adherence between patients seen by a sleep specialist prior to OSA diagnosis versus patients referred directly for OSA testing by non-sleep specialist providers. The goal of the study was to understand the impact of sleep consultation on PAP adherence.
Methods
Direct referral (DR) patients underwent polysomnography (PSG) and received PAP devices prior to the sleep clinic visit. In contrast, sleep center patients (SC) had a sleep clinic visit with a sleep physician or APRN prior to PSG.
Eighty-four patients were included in this study, 42 DR and 42 SC patients. Exclusion criteria were age <18 years old, absence of baseline PSG, and lack of 90-day compliance data. Covariates included demographics, body mass index (BMI), AHI, nadir oxygen saturation, demographics, and Epworth Sleepiness Scale (ESS) score. Objective PAP adherence for first 90 days was the primary outcome.
Results
Age (p=0.1), ESS (p=0.3), BMI (p=0.6), and AHI (p=0.9) were not significantly different between the groups. SC patients had greater PAP adherence (4.77 hours, 95%CI: 4.1 to 5.4) compared to DR patients (3.61 hours, 95%CI: 2.88 to 4.33, p=0.02). SC patients were also 8 times more likely to follow up in clinic within 1 year of starting PAP treatment (Likelihood Ratio 8.25, p=0.004).
Conclusion
While possibly more time-efficient for patients, direct referrals may ultimately result in lower PAP adherence due to missed opportunities for receiving education about OSA and PAP therapy. This is consistent with findings from a previous meta-analysis demonstrating that educational interventions improve PAP adherence. Moving forward, we will continue encouraging directly referred patients to follow up in the sleep center after PSG.
Support
None</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/sleep/zsaa056.636</doi><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Medical referrals Sleep apnea Systematic review |
| title | 0640 Initial Sleep Center Evaluation and Follow Up Improves Positive Airway Pressure (PAP) Therapy Adherence When Compared to Direct Referrals Without Sleep Physician Follow Up: A Retrospective Study |
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