A mannequin for sleep apnea administration in underserved affected person populations

This article was originally published here

J Prim Care Community Health. 2022 Jan-Dec;13:21501319211068969. doi: 10.1177/21501319211068969.

ABSTRACT

INTRODUCTION: Obstructive sleep apnea (OSA) is a common condition in the United States that is strongly associated with metabolic disease, cardiovascular disease, and mortality. Uninsured populations experience sleep health disparities, including delayed detection, diagnosis, and treatment of OSA due to barriers in accessing and providing care. Partnerships between primary care clinics and sleep medicine professionals for sleep apnea management have the potential to improve screening, testing and treatment in populations. Here we present an integrated and cost-effective model that is easier for patients to navigate while ensuring care.

METHODS: We designed and implemented a dedicated sleep clinic at the Shade Tree Clinic, Vanderbilt’s student-run, free primary care clinic. Patients with signs and symptoms of OSA were identified at primary care appointments and assessed using the STOP-BANG questionnaire. Clinic visits took place via telemedicine with a medical student and a sleep specialist. Patients were diagnosed using a home sleep test and, if indicated, were prescribed and given a CPAP machine for treatment. CPAP compliance was monitored using a cloud-based remote monitoring system.

RESULTS: From December 2020 to August 2021, we hosted 6 telemedicine sleep clinics and saw a total of 28 patients at these visits. We have received a total of 37 referrals and have coordinated sleep assessments and diagnostic tests for 18 of these patients to date. Prior to the start of the sleep clinic, there were 17 patients on our primary care panel at Shade Tree with an OSA diagnosis. These patients were using donated devices, and many were lost or had broken parts during follow-up. We were able to replace 10 of these patients’ CPAP machines and plan to replace the remaining seven.

CONCLUSIONS: We have created an efficient and cost-effective model of integrated specialty care. This paradigm can be replicated for the many specialties that are typically overlooked and undertreated when working with uninsured patients. As awareness of this sleep medicine program at Shade Tree Clinic continues to grow, we expect to reach more primary care patients with signs and symptoms of sleep apnea through student education, low-cost diagnostics, and partnerships with sleep professionals.

PMID:35040343 | DOI:10.1177/21501319211068969

Leave a comment

Your email address will not be published. Required fields are marked *