Abstract
Introduction
The American Academy of Sleep Medicine (AASM) guidelines for treatment of Obstructive Sleep Apnea (OSA) with Positive Airway Pressure (PAP) state good practice standards involve adequate follow up with a clinician tele-monitoring efficacy through objective usage data to ensure acceptable treatment and compliance is met, and provide education, behavioral and/or troubleshooting interventions. In 2016, Dayton Children’s Hospital’s pap compliance was 29% due to limited staff support.
Methods
To efficiently implement the AASM guidelines, one dedicated Respiratory Therapist (RT) was assigned to help manage OSA patients at Dayton Children’s Sleep Medicine. The RT responsibilities include, PAP therapy education, arranging home PAP system, and a follow-up call within 7 days of setup. Through the tele-monitoring system, the RT assesses compliance and addresses equipment issues and mask fitting at the 4 to 6 week clinic visit. To enhance compliance, a welcome postcard and gift card were implemented. Monthly clinic visits occur until compliance is met, wearing device greater than 4 hours 60% of the time, then appointments are scheduled every 6 months to 1 year.
Results
Since 2016, compliance rate increased from 29% to 58%. There was a year over year growth of number of patients starting therapy from 2017 to 2019, 86 patients were added to the PAP program. In 2019, 60% of 6 to 12 years old met compliance and 51% of 13 to 18 years old.
Conclusion
A comprehensive PAP program resulted in improved compliance and substantial growth. Referring providers and families are more likely to accept PAP therapy when made aware of extensive education and follow up by RT staff. To further improve compliance, especially in the 13 to 18 age range, a desensitization program has recently been implemented.
Support
No support provided.
In reference to Positive Airway Pressure Titration Task Force of the American Academy of Sleep Medicine