Impact of the sleep apnea management group clinic on positive airway pressure adherence.

Autor: Tran K; Center for Sleep and Breathing Disorders, UT Southwestern University, Dallas, TX, USA., Wang L; Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA., Mehra R; Sleep Disorders Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA., Vanek R; Sleep Disorders Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA., Kaw S; Sleep Disorders Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA., Campean T; Sleep Disorders Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA., Foldvary-Schaefer N; Sleep Disorders Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA., Moul DE; Sleep Disorders Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA., Walia H; Sleep Disorders Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA. Harneet_walia@yahoo.com.
Jazyk: angličtina
Zdroj: Sleep & breathing = Schlaf & Atmung [Sleep Breath] 2022 Mar; Vol. 26 (1), pp. 189-194. Date of Electronic Publication: 2021 Apr 29.
DOI: 10.1007/s11325-021-02352-w
Abstrakt: Background: Positive airway pressure (PAP) adherence is critical for managing obstructive sleep apnea (OSA). We postulate that group-based Sleep Apnea Management (SAM) clinic, which harnesses the benefits of providing mutual support as well as facilitates access to system-based resources and education, will confer improvements in PAP adherence.
Methods: Data from SAM clinic attendees from January 2017 to June 2018 were retrospectively analyzed. Adherence data at SAM baseline visit and 1-3 months follow-up were collected. Average PAP usage from all-days and days used were analyzed along with demographics, co-morbidities, and Epworth Sleepiness Scale. Adherence was defined as >4 hours a night for ≥70% of nights over a 30-day period. Key structural elements of the SAM group clinic model were co-presence of the OSA care team members and peer group support. Key efficiency elements were group education and the prompt-to-patient multidisciplinary troubleshooting adherence barriers.
Results: Of 110 SAM clinic attendees, average age was 60.9±12.7 years, 53% were men, and 46% Caucasian. At baseline, the mean for average-all-days usage was 4.2 hours, mean average-days-used usage was 5.2 hours, and mean percentage-of-days usage ≥4 hours was 57%. At follow-up, the mean average-all-days usage increased 1.2 hours (p<0.001), mean average-days-used usage increased 0.8 hours (p<0.001), and the mean percentage-of-days with usage ≥4 hours increased 16% (p<0.001). At baseline, 46% of patients met criteria for adherence, which increased to 66% at follow-up.
Conclusion: In this study, after the SAM clinic, all PAP adherence parameters improved significantly. This observational study serves as a proof of concept study for future trials pertaining to group clinic in managing PAP adherence in OSA.
(© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Databáze: MEDLINE
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