Assessing and predicting the likelihood of interventions during routine annual follow-up visits for management of obstructive sleep

Srikant Nannapaneni, Timothy Ian Morgenthaler, Kannan Ramar

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Study Objectives: Patients with obstructive sleep apnea (OSA) on established positive airway pressure (PAP) treatment are often advised routine annual follow-up visits to assess ongoing effectiveness and address problems associated with therapy. This study evaluates the clinical utility of annual face-to-face follow-up visits. Design: We performed a retrospective chart review of OSA patients on PAP who had completed a routine annual follow-up visit. Demographics, polysomnography, PAP compliance, Epworth Sleepiness Scale (ESS), subjective complaints (efficacy and interface issues, equipment malfunction, prescription renewal), objective findings (efficacy or leak issues, equipment problems), and visit-specific interventions were recorded. We determined relationships between patient provided information and likelihood of therapeutic versus administrative interventions. Setting: Academic sleep center. Measurements and Results: Among 716 patients who met study criteria, we abstracted data on 180 randomly selected patients. On multivariate analyses, only subjective complaints or objective findings by providers were associated with a therapeutic intervention (p < 0.0001). Though most patients (55 of 63 patients, 87.3%) who required therapeutic interventions had objective findings, without subjective complaints, the odds of such findings were only 0.12 (95% CI = 0.06-0.24, p < 0.0001). Without subjective complaints, the likelihood of a therapeutic intervention was 0.07 (95% CI = 0.03-0.15, p < 0.001). Conclusion: Our data suggests that in the absence of a subjective complaint, an annual follow-up is more likely to require administrative rather than face-to-face clinical intervention. Designing a clinic model to account for this might reduce resource utilization. However, the value and optimal timing of "routine" annual follow-up visits requires further evaluation.

Original languageEnglish (US)
Pages (from-to)919-924
Number of pages6
JournalJournal of Clinical Sleep Medicine
Volume10
Issue number8
DOIs
StatePublished - 2014

Keywords

  • Clinic visits
  • Complaints
  • CPAP
  • Follow-up
  • Obstructive sleep apnea

ASJC Scopus subject areas

  • Clinical Neurology
  • Pulmonary and Respiratory Medicine
  • Neurology

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