Remote Ambulatory Management of Veterans with Obstructive Sleep Apnea
Remote Ambulatory Management of Veterans with Obstructive Sleep Apnea
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DOI：
10.5665/sleep.5514
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发表时间：
2016-03-01
期刊：
影响因子：
5.6
通讯作者：
Kuna, Samuel T.
中科院分区：
文献类型：
--
作者：
Fields, Barry G.;Behari, Pratima Pathak;Kuna, Samuel T.
研究目的：尽管阻塞性睡眠呼吸暂停（OSA）有显著的医学后遗症，但在许多受影响的个体中，该病症仍然未被诊断和治疗。我们探讨了一个全面的，基于远程医疗的OSA管理途径在社区为基础的Veteran cohort.Methods的可行性：这种前瞻性，平行组随机试点研究评估的可行性，基于远程医疗的途径OSA的评价和管理相比，一个更传统的，在人的护理模式。这项研究包括费城退伍军人事务医疗中心和两个附属社区门诊诊所的60名退伍军人。远程医疗路径的可行性，可接受性和结果进行了评估，通过各种定量（睡眠问卷的功能结局、脱落率、气道正压通气[PAP]依从率、参与者满意度评级）和定性（口头反馈）指标。结果：在功能结局变化、患者满意度、脱落率、或客观测量治疗3个月后两组间的PAP依从性。远程医疗参与者表现出更大的改善心理健康评分，他们的反馈是压倒性的positive.Conclusions：我们的试点研究表明，基于远程医疗的管理OSA患者是可行的，在病人的功能结果和整体满意度护理。未来的研究应包括更大的人群，以进一步阐明这些发现，同时评估供应商和患者相关的成本效益。
Study Objectives: Despite significant medical sequelae of obstructive sleep apnea (OSA), the condition remains undiagnosed and untreated in many affected individuals. We explored the feasibility of a comprehensive, telemedicine-based OSA management pathway in a community-based Veteran cohort.Methods: This prospective, parallel-group randomized pilot study assessed feasibility of a telemedicine-based pathway for OSA evaluation and management in comparison to a more traditional, in-person care model. The study included 60 Veterans at the Philadelphia Veterans Affairs Medical Center and two affiliated community-based outpatient clinics. Telemedicine pathway feasibility, acceptability, and outcomes were assessed through a variety of quantitative (Functional Outcomes of Sleep Questionnaire, dropout rates, positive airway pressure [PAP] adherence rates, participant satisfaction ratings) and qualitative (verbal feedback) metrics.Results: There was no significant difference in functional outcome changes, patient satisfaction, dropout rates, or objectively measured PAP adherence between groups after 3 months of treatment. Telemedicine participants showed greater improvement in mental health scores, and their feedback was overwhelmingly positive.Conclusions: Our pilot study suggests that telemedicine-based management of OSA patients is feasible in terms of patient functional outcomes and overall satisfaction with care. Future studies should include larger populations to further elucidate these findings while assessing provider-and patient-related cost effectiveness.