Veteran Preferences Regarding Wireless Management of Positive Airway Pressure for Obstructive Sleep Apnea at a Tertiary Health-Care System
Veteran Preferences Regarding Wireless Management of Positive Airway Pressure for Obstructive Sleep Apnea at a Tertiary Health-Care System
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DOI：
10.4187/respcare.05002
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发表时间：
2017-03-02
期刊：
影响因子：
2.5
通讯作者：
Parsons, Elizabeth C.
中科院分区：
文献类型：
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作者：
He, Ken;Palen, Brian N.;Parsons, Elizabeth C.
背景：在患者数量增加和睡眠药物提供者短缺的冲突压力下，及时监测阻塞性睡眠呼吸暂停（OSA）治疗可能是一项挑战。采用无线调制解调器技术的气道正压（PAP）设备有可能改善患者获得护理的机会并简化工作量，但对于患有睡眠呼吸暂停的退伍军人中患者对远程医疗整合的态度知之甚少。作为退伍军人事务部（VA）普吉特海湾医疗保健系统（Puget Sound Health Care System）质量改进计划的一部分，我们调查了退伍军人对现代和传统PAP数据下载的偏好，包括患者态度和影响这些偏好的因素。方法：我们对以前没有CPAP经验的退伍军人进行了匿名调查，这些退伍军人在VA普吉特湾PAP诊所进行了初始设备设置和培训。调查评估了受试者的人口统计、PAP下载偏好（调制解调器与邮件），以及Likert类型对便利性和信息隐私等因素的重要性评级。使用多项逻辑回归，我们检验了便利评级和下载偏好之间的关系，调整了信息隐私评级、年龄和通勤时间。结果：在分析的444份调查中，受访者主要是男性，平均年龄为52岁。大多数受访者报告通勤到PAP诊所需要>= 30分钟。便利性被认为是影响下载偏好的最重要因素。老兵对PAP下载方法的偏好参差不齐，47%的人喜欢调制解调器，38%的人喜欢内存卡邮寄，15%的人没有决定。在调整信息隐私等级、通勤时间和退伍军人年龄之前和之后，较高的便利等级与现代偏好显著相关(调整后的相对风险比1.67，P
BACKGROUND: Timely monitoring of obstructive sleep apnea (OSA) therapy can be a challenge amid conflicting pressures of rising patient volume and shortage of sleep medicine providers. Positive airway pressure (PAP) devices with wireless modem technology have the potential to improve patient access to care and streamline work load, yet little is known about patient attitudes toward telehealth integration among veterans with sleep apnea. As part of a larger quality improvement initiative at the Veterans Affairs (VA) Puget Sound Health Care System, we elicited veterans' preferences toward modem versus traditional PAP data download, including patient attitudes and factors affecting those preferences. METHODS: We conducted an anonymous survey of veterans without previous CPAP experience presenting for initial device setup and training at VA Puget Sound PAP clinics. Surveys assessed subject demographics, PAP download preferences (modem vs mail), and Likert- type scale ratings of importance placed on factors including convenience and information privacy. Using multinomial logistic regression, we examined the association between convenience rating and download preference, adjusting for information privacy rating, age, and commute time. RESULTS: Of 444 surveys analyzed, respondents were primarily male with a mean age of 52 y. Most respondents reported taking >= 30 min to commute to the PAP clinic. Convenience was rated as the most important factor affecting download preferences. Veteran preferences regarding PAP download method were mixed, with 47% preferring modem, 38% preferring memory card mail- in, and 15% undecided. A higher rating of convenience was significantly associated with modem preference, both before and after adjustment for information privacy rating, commute time, and veteran age (adjusted relative risk ratio 1.67, P