https://doi.org/10.4081/monaldi.2023.2673
Comparison among three different follow-up models for obstructive sleep apnea syndrome patients: focus on the physiotherapist’s role
Submitted: June 22, 2023
Accepted: September 28, 2023
Published: October 4, 2023
Accepted: September 28, 2023
Abstract Views: 743
PDF: 68
SUPPLEMENTARY MATERIAL: 38
SUPPLEMENTARY MATERIAL: 38
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
In obstructive sleep apnea syndrome (OSAS) subjects, different follow-up modalities have been proposed to improve adherence to the continuous positive airway pressure (CPAP) device. This retrospective study compares three different health professional approaches dedicated to caring for OSAS patients in three consecutive follow-up periods of 15 months each. The three different follow-up models are i) physician-oriented follow-up (P-F), ii) physiotherapist-oriented follow-up (PT-F), and iii) tele-titration plus PT-oriented follow-up (TT-PT-F). Health personal visits and actions delivered, patients’ adherence, CPAP efficacy, and problems under CPAP use were considered for comparison. Data from 122 OSAS patients with a new prescription of CPAP were analyzed: 39 (32.0%) in the P-F, 38 (31.1%) in the PT-F, and 45 (36.9%) in the TT-PT-F period. We found a reduction over time (from 40.9% in P-F to 8.2% in TT-PT-F, p<0.001) in patients missing the 1-year follow-up visit. The PT-F and TT-PT-F lead to a reduction in physician visits in comparison to P-F (5.2% and 8.9% vs. 100%, p<0.001) with no differences in time to the first follow-up visit, CPAP efficacy, and patients’ adherence among the three periods. More device-related problems were found in the PT-F (57.8%), compared with the PF (25.6%) period (p<0.001); the most common troubles were mask problems evaluated in 26.2% of cases. In conclusion, different follow-up models offer similar efficacy and short-term adherence for CPAP, leading to a significant reduction in physician visits under the PT-F with or without tele-titration, with mask problems as the most commonly treated. Further analysis should be useful to define the best cost-efficacy follow-up intervention.
Senaratna CV, Perret JL, Lodge CJ, et al. Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev 2017;34:70-81.
Peppard PE, Young T, Barnet JH, et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013;177:1006-14.
Lim DC, Pack AI. Obstructive sleep apnea: update and future. Annu Rev Med 2017;68:99-112.
Patil SP, Ayappa IA, Caples SM, et al. Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med 2019;15:335-43.
Blau A, Minx M, Peter JG, et al. Auto bi-level pressure relief-PAP is as effective as CPAP in OSA patients--a pilot study. Sleep Breath 2012;16:773-9.
Huseini T, McArdle N, Jasper E, et al. The use and effectiveness of adaptive servo-ventilation in central sleep apnea: a study of consecutive sleep clinic patients. J Sleep Res 2020;29:e13016.
Bakker JP, Weaver TE, Parthasarathy S, et al. Adherence to CPAP: what should we be aiming for, and how can we get there? Chest.2019;155:1272-87.
Pépin JL, Krieger J, Rodenstein D, et al. Effective compliance during the first 3 months of continuous positive airway pressure. A European prospective study of 121 patients. Am J Respir Crit Care Med 1999;160:1124-9.
Pépin JL, Tamisier R, Hwang D, et al. Does remote monitoring change OSA management and CPAP adherence? Respirology 2017;22:1508-17.
Sawyer AM, Gooneratne N, Marcus CL, et al. A systematic review of CPAP adherence across age groups: clinical and empiric insights for developing CPAP adherence interventions. Sleep Med Rev 2011;15:343-56.
Scioscia G, Tondo P, Foschino Barbaro MP, et al. Machine learning-based prediction of adherence to continuous positive airway pressure (CPAP) in obstructive sleep apnea (OSA). Inform Health Soc Care 2022;47:274-82.
Antic NA, Buchan C, Esterman A, et al. A randomized controlled trial of nurse-led care for symptomatic moderate-severe obstructive sleep apnea. Am J Respir Crit Care Med 2009;179:501-8.
Olsen S, Smith SS, Oei TP, et al. Motivational interviewing (MINT) improves continuous positive airway pressure (CPAP) acceptance and adherence: a randomized controlled trial. J Consult Clin Psychol 2012;80:151-63.
Epstein LJ, Kristo D, Strollo PJ, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009;5:263-76.
Simonelli C, Paneroni M, Vitacca M. An implementation protocol for noninvasive ventilation prescription: the physiotherapist’s role in an Italian hospital. Respir Care 2013;58:662-8.
Vignatelli L, Plazzi G, Barbato A, et al. Italian version of the Epworth sleepiness scale: external validity. Neurol Sci 2003;23:295-300.
Pépin JL, Tamisier R, Baguet JP, et al. Fixed-pressure CPAP versus auto-adjusting CPAP: comparison of efficacy on blood pressure in obstructive sleep apnoea, a randomised clinical trial. Thorax 2016;71:726-33.
Vennelle M, White S, Riha RL, et al. Randomized controlled trial of variable-pressure versus fixed-pressure continuous positive airway pressure (CPAP) treatment for patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Sleep 2010;33:267-71.
Johns MW. Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale. Chest 1993;103:30-6.
Holmdahl C, Schollin IL, Alton M, et al. CPAP treatment in obstructive sleep apnoea: A randomized, controlled trial of follow-up with a focus on patient satisfaction. Sleep Med 2009;10:869-74.
Jambhekar SK, Com G, Tang X, et al. Role of a respiratory therapist in improving adherence to positive airway pressure treatment in a pediatric sleep apnea clinic. Respir Care 2013;58:2038-44.
Russo-Magno P, O’Brien A, Panciera T, Rounds S. Compliance with CPAP therapy in older men with obstructive sleep apnea. J Am Geriatr Soc 2001;49:1205-11.
Pelletier-Fleury N, Rakotonanahary D, Fleury B. The age and other factors in the evaluation of compliance with nasal continuous positive airway pressure for obstructive sleep apnea syndrome. A Cox’s proportional hazard analysis. Sleep Med 2001;2:225–32.
DeMolles DA, Sparrow D, Gottlieb DJ, et al. A pilot trial of a telecommunications system in sleep apnea management. Med Care 2004;42:764–9.
Smith CE, Dauz ER, Clements F, et al. Telehealth services to improve nonadherence: A placebo-controlled study. Telemed J E Health 2006;12:289-96.
Sparrow D, Aloia MS, DeMolles DA, et al. A telemedicine intervention to improve adherence to continuous positive airway pressure: a randomised controlled trial. Thorax 2010;65:1061-66.
Stepnowsky CJ, Palau JJ, Marler MR, et al. Pilot randomized trial of the effect of wireless telemonitoring on compliance and treatment efficacy of obstructive sleep apnea. J Med Internet Res 2007;9:e14.
Taylor Y, Eliasson AH, Andrada T, et al. The role of telemedicine in CPAP compliance for patients with obstructive sleep apnea syndrome. Sleep Breath 2006;10:132-8.
Ethics Approval
This study was approved by the Institutional Review Board of Istituti Clinici Scientifici (ICS) Maugeri (2481CE, October 6th, 2020).How to Cite
Simonelli, Carla, Michele Vitacca, Beatrice Salvi, Manuela Saleri, and Mara Paneroni. 2023. “Comparison Among Three Different Follow-up Models for Obstructive Sleep Apnea Syndrome Patients: Focus on the physiotherapist’s Role”. Monaldi Archives for Chest Disease 94 (4). https://doi.org/10.4081/monaldi.2023.2673.
Copyright (c) 2023 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Marco Ambrosetti, Patrick Doherty, Pompilio Faggiano, Ugo Corrà, Carlo Vigorito, Dominique Hansen, Patrizio Sarto, Ana Abreu, Roberto F.E. Pedretti, Characteristics of structured physical training currently provided in cardiac patients: insights from the Exercise Training in Cardiac Rehabilitation (ETCR) Italian survey , Monaldi Archives for Chest Disease: Vol. 87 No. 1 (2017)
- Sryma PB, Saurabh Mittal, Karan Madan, Anant Mohan, Pawan Tiwari, Vijay Hadda, Ravindra Mohan Pandey, Randeep Guleria, Awake prone positioning in non-intubated patients for the management of hypoxemia in COVID-19: A systematic review and meta-analysis , Monaldi Archives for Chest Disease: Vol. 91 No. 2 (2021)
- Pankti Sheth Ketan, Rohit Kumar, Mahendran AJ, Pranav Ish, Shibdas Chakrabarti, Neeraj Kumar Gupta, Nitesh Gupta, Post-extubation high-flow nasal cannula oxygen therapy versus non-invasive ventilation in chronic obstructive pulmonary disease with hypercapnic respiratory failure , Monaldi Archives for Chest Disease: Vol. 94 No. 2 (2024)
- Manu Madan, Rohit Kumar, Pranav Ish, Yash Kedia, AJ Mahendran, Rajnish Kaushik, Neeraj Kumar Gupta, Nitesh Gupta, Additional yield of transbronchial cryo-node biopsy over endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal lesions at a tertiary care center in India (COLD-FORCEPS-2 study) , Monaldi Archives for Chest Disease: Early Access
- Sreyas Sharma, Nitesh Gupta, Pranav Ish, Rajnish Kaushik, Neeraj Kumar Gupta, Tanmaya Talukdar, Rohit Kumar, Comparative study between ultrasound-guided closed pleural biopsy and thoracoscopic pleural biopsy in undiagnosed exudative pleural effusions , Monaldi Archives for Chest Disease: Early Access
- Paolo Ruggeri, Federica Lo Bello, Francesco Nucera, Michele Gaeta, Francesco Monaco, Gaetano Caramori, Giuseppe Girbino, Hereditary hyperhomocysteinemia associated with nephrotic syndrome complicated by artery thrombosis and chronic thromboembolic pulmonary hypertension: A case report , Monaldi Archives for Chest Disease: Vol. 87 No. 3 (2017)
- Silvia Faverzani, Filippo Nocera, Ernesto Crisafulli, Maurizio Marvisi, Andrea Becciolini, Federica Mosetti, Eleonora Di Donato, Flavio Mozzani, Daniele Santilli, Giuseppe Scopelliti, Alarico Ariani, Home-based unsupervised pulmonary rehabilitation program improves the respiratory disability in systemic sclerosis patients with dyspnea: an observational prospective study , Monaldi Archives for Chest Disease: Vol. 92 No. 3 (2022)
- Tarun Krishna Boppana, Saurabh Mittal, Karan Madan, Anant Mohan, Vijay Hadda, Pawan Tiwari, Randeep Guleria, Steroid therapy for COVID-19: A systematic review and meta-analysis of randomized controlled trials , Monaldi Archives for Chest Disease: Vol. 91 No. 4 (2021)
- Laura Bertacchini, Mara Paneroni, Laura Comini, Simonetta Scalvini, Michele Vitacca, Recovering of oxygenation, physical function and disability in patients with Covid-19 , Monaldi Archives for Chest Disease: Vol. 91 No. 4 (2021)
- Gabriella Malfatto, Anna Frisinghelli, Marco Ambrosetti, Maria Teresa La Rovere, Irene Motta, Bruno Passaretti, Marco Pavesi, Roberto Tramarin, Niccolò Dasseni, Pompilio Faggiano, Iron deficiency from the standpoint of cardiac rehabilitation: novel therapeutic opportunities , Monaldi Archives for Chest Disease: Vol. 89 No. 3 (2019)
<< < 9 10 11 12 13 14 15 16 17 18 > >>
You may also start an advanced similarity search for this article.
