Using Telemedicine to Improve Veteran Sleep Apnea Care

使用远程医疗改善退伍军人睡眠呼吸暂停护理

• 批准号: 8088340
• 负责人: Carl J. Stepnowsky
• 金额: --
• 依托单位: VA SAN DIEGO HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8088340
• 关键词: 18 year old; Address; Adherence; Age; Arousal; Caring; Chronic; Clinic; Clinical; Clinical Trials; Communication; Consultations; Continuous Positive Airway Pressure; Diagnosis; Education; Enrollment; Exclusion Criteria; Feedback; Gender; Goals; Gold; Healthcare; Home environment; Hypoxia; Intervention; Learning; Measures; Methods; Obstructive Sleep Apnea; Outcome; Overweight; Patient Self-Report; Patients; Pattern; Pilot Projects; Population; Privacy; Process; Provider; Quality of Care; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Recruitment Activity; Relative (related person); Research; Risk Factors; Screening procedure; Sleep; Sleep Apnea Syndromes; Symptoms; System; Technology; Telemedicine; Time; Treatment Efficacy; Veterans; Visual; Work; airway obstruction; base; clinical care; collaborative care; cost; design; effective intervention; experience; improved; inclusion criteria; male; novel; patient oriented; standard care; treatment adherence; treatment as usual; willingness

DESCRIPTION (provided by applicant): Anticipated Impact on Veteran's Healthcare: The findings of this study have the potential to improve the quality of clinical care provided to Veteran patients with obstructive sleep apnea who are prescribed CPAP. Project Background: Obstructive sleep apnea (OSA) is highly prevalent in the Veteran population given the risk factors of male gender, being overweight, and increasing age. OSA is caused by upper airway obstruction, resulting in arousals from sleep and hypoxia. While continuous positive airway pressure (CPAP) is a highly efficacious treatment for OSA, compliance with treatment is suboptimal. Because research shows that adherence patterns are established early in treatment, we seek to use a technology that enables early and frequent productive interactions between patient and provider Project Objectives: The objective of this proposal is to explore the feasibility and initially evaluate the potential efficacy of a video teleconferencing system for patients with Obstructive Sleep Apnea syndrome (OSA) that facilitates patient- centered, collaborative management for patients who are prescribed the gold-standard treatment, continuous positive airway pressure (CPAP). Project Methods: The evaluative aspect of this proposal is designed as a pilot randomized, controlled clinical trial-Video Teleconferencing compared to Usual Care. The key feature of the Video Teleconferencing intervention is the use of a telemedicine system that allows for audio/visual conferencing with the patient in their home environment from the start of treatment initialization. The provider is able provide more directed feedback to the patient based on the telemedicine interaction, and the patient benefits from increased contact with the provider. Specific inclusion and exclusion criteria will be used, including, age > 18 years; confirmed diagnosis of moderate-severe OSA; being newly prescribed CPAP therapy; having chronic symptoms as noted on screening symptom checklist; and fluency in English. Patients will be recruited from local Sleep Clinics. Patients will be enrolled for a 2-month time period. Groups will be compared on quantitative and qualitative measures.

描述（由申请人提供）： 对退伍军人医疗保健的预期影响：本研究的结果有可能提高为患有阻塞性睡眠呼吸暂停的退伍军人患者提供的CPAP临床护理质量。项目背景：阻塞性睡眠呼吸暂停（OSA）在退伍军人群体中非常普遍，因为男性性别，超重和年龄增加是危险因素。阻塞性睡眠呼吸暂停综合征是由上呼吸道阻塞引起的，导致睡眠和缺氧。虽然持续气道正压通气（CPAP）是一种非常有效的治疗OSA，治疗的依从性是次优的。由于研究表明，依从性模式是在治疗早期建立的，因此我们寻求使用一种技术，使患者和提供者之间能够早期和频繁地进行富有成效的互动。本提案的目的是探索视频电话会议系统的可行性，并初步评估其对阻塞性睡眠呼吸暂停综合征（OSA）患者的潜在疗效，为接受金标准治疗（持续气道正压通气（CPAP））的患者提供协作管理。项目方法：该提案的评价方面被设计为一项试点随机对照临床试验-视频会议与家庭护理相比。视频会议干预的关键特征是使用远程医疗系统，允许从治疗初始化开始在患者的家庭环境中与患者进行音频/视频会议。提供者能够基于远程医疗交互向患者提供更直接的反馈，并且患者受益于与提供者的增加的接触。将使用特定的入选和排除标准，包括年龄> 18岁;确诊为中重度OSA;新处方CPAP治疗;具有筛选症状检查表上记录的慢性症状;英语流利。患者将从当地睡眠诊所招募。患者将入组2个月。各组将在定量和定性指标上进行比较。