Enabling Sleep Apnea Patient-Centered Care Via an Internet Intervention

这项提议的目的是检验一种新型的可互操作的互联网的效果。 干预？用于集成遥测的阻塞性睡眠呼吸暂停综合征(OSA)患者 治疗设备和基于互联网的门户，促进以患者为中心的协作 管理患者开出的金标准治疗，持续正压气道 压力(CPAP)。CPAP治疗依从性差是有据可查的。与…相抗衡 远程医疗应用的背景下，未经证实的索赔和 患者满意度、诊断准确性、临床疗效和成本效益的假设 他们在技术上的成熟度和能力，这项提案的评估方面是 设计为随机对照临床试验？普通护理患者(对照)与I-PAP 患者(干预)。该项目的一个重要的经验方法论优势是 CPAP依从性的客观测量，由内部微处理器作为 ？在规定压力下使用CPAP的时间量。这一客观衡量标准允许 对患者和提供者的治疗依从性和疗效的反馈，我们设计了 围绕这一中心特征的i-PAP干预。 因为众所周知，依从性模式是在治疗的早期就建立起来的，i-PAP是 旨在为CPAP新用户提供入门所需的教育和支持 CPAP：学习中心提供有关OSA和CPAP的教育； 故障排除指南帮助患者排除和解决CPAP问题；我的图表 不仅可以用图形表示治疗依从性数据，还可以用图形表示治疗效果数据 我的日记允许记录患者的经历？S的经历；我的评估允许 让患者输入他们自己的数据，并跟踪他们在多项措施上的进展；我的信息 董事会促进了与睡眠提供者(以及未来其他阻塞性睡眠呼吸暂停患者)的及时互动。 本质上，i-PAP旨在提供患者想要和需要的护理，当时他们 想要也需要它。本项目的总体目标是检查这种以患者为中心的治疗效果， 协作式护理？互联网干预？提高CPAP对临床的依从性 有意义的水平，并审查这一影响的潜在调解人。核心问题是 包括研究的概念性和经验性轮廓：i-PAP干预是否具有 对患者的影响？S的护理经验、持续气道正压治疗的依从性和阻塞性睡眠呼吸暂停的结局 通常的护理，如果是这样的话，解释这种影响的可能机制是什么？

The objective of this proposal is to examine the effect of a novel interoperable ?internet intervention? for patients with Obstructive Sleep Apnea syndrome (OSA) that integrates a telemetry treatment device and an internet-based portal that facilitates patient-centered, collaborative management for patients prescribed the gold-standard treatment, continuous positive airway pressure (CPAP). Poor treatment adherence with CPAP therapy is well-documented. Set against a backdrop of telemedicine applications that have grown as fast in unsubstantiated claims and assumptions of patient satisfaction, diagnostic accuracy, clinical efficacy, and cost-effectiveness as they have in technological sophistication and capabilities, the evaluative aspect of this proposal is designed as a randomized, controlled clinical trial?Usual Care patients (control) versus i-PAP patients (intervention). An important empirical-methodological advantage of the project is the objective measurement of CPAP adherence, which is measured by internal microprocessor as the ?amount of time CPAP is used at the prescribed pressure.? This objective measurement allows feedback of treatment adherence and efficacy to both patient and provider, and we have designed the i-PAP intervention around this central feature. Because it is well-known that adherence patterns are established very early in treatment, i-PAP is designed to provide new CPAP users with education and support they require to get started on CPAP: The Learning Center provides education about OSA and CPAP; the interactive Troubleshooting Guide helps the patients troubleshoot and solve CPAP problems; My Charts allows graphical representation not only of treatment adherence data, but treatment efficacy data as well; My Journal allows the journaling of the patient?s experiences; My Assessments allow the patients to enter their own data and track their progress on a number of measures; My Message Board facilitates timely interactions with sleep providers (and in the future other OSA patients). Essentially, i-PAP is designed to provide the care that patients want and need, at the time they want and need it. The overarching aim of the present project is to examine the effect of this patientcentered, collaborative care ?internet intervention? on increasing CPAP adherence to a clinically meaningful level and to examine the potential mediators of this effect. The central questions that encompass the conceptual and empirical contours of the study: Does the i-PAP intervention have an effect on the patient?s experience of care, CPAP adherence, and OSA outcomes relative to usual care, and if so, what are the possible mechanisms that account for the effect?