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An observational study of the effectiveness of alternative care providers in the management of obstructive sleep apnea
Author(s) -
Pendharkar Sachin R.,
Dechant Anthony,
Bischak Diane P.,
Tsai Willis H.,
Stevenson AnnMarie,
Hanly Patrick J.
Publication year - 2016
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/jsr.12358
Subject(s) - epworth sleepiness scale , obstructive sleep apnea , medicine , continuous positive airway pressure , positive airway pressure , observational study , excessive daytime sleepiness , sleep apnea , physical therapy , patient satisfaction , airway , intensive care medicine , apnea , sleep disorder , polysomnography , insomnia , nursing , anesthesia , psychiatry
Summary Alternative care providers have been proposed as a substitute for physician‐based management of obstructive sleep apnea. The purpose of this study was to describe the clinical course of patients with a new diagnosis of obstructive sleep apnea who were treated with continuous positive airway pressure and followed by alternative care providers at a tertiary care sleep clinic. It was hypothesized that care by alternative care providers would result in improvement of daytime sleepiness and satisfactory treatment adherence, and that a specific number of follow‐up visits could be identified after which clinical outcomes no longer improved. The Epworth Sleepiness Scale score was measured for each patient at baseline and at each alternative care provider visit. Patients were discharged when they demonstrated a significant improvement in sleepiness and were adherent to therapy. The Epworth Sleepiness Scale score decreased by 3.9 points from baseline to discharge. Patients with three or more visits required more follow‐up time to achieve the same clinical improvement as those with only two visits. Continuous positive airway pressure adherence was comparable to previous studies of physician‐led care and improved with ongoing alternative care provider follow‐up. The current results suggest that clinical care by alternative care providers leads to continued improvements in sleepiness in patients with obstructive sleep apnea who are treated with continuous positive airway pressure, and that a minority of patients require longer follow‐up to achieve a satisfactory clinical response to therapy.