Enabling Sleep Apnea Patient-Centered Care Via an Internet Intervention

Veterans Medical Research Fdn/San Diego, San Diego CA

Investigators

Abstract

The objective of this proposal is to examine the effect of a novel interoperable ?internet[unreadable] intervention? for patients with Obstructive Sleep Apnea syndrome (OSA) that integrates a telemetry[unreadable] treatment device and an internet-based portal that facilitates patient-centered, collaborative[unreadable] management for patients prescribed the gold-standard treatment, continuous positive airway[unreadable] pressure (CPAP). Poor treatment adherence with CPAP therapy is well-documented. Set against a[unreadable] backdrop of telemedicine applications that have grown as fast in unsubstantiated claims and[unreadable] assumptions of patient satisfaction, diagnostic accuracy, clinical efficacy, and cost-effectiveness as[unreadable] they have in technological sophistication and capabilities, the evaluative aspect of this proposal is[unreadable] designed as a randomized, controlled clinical trial?Usual Care patients (control) versus i-PAP[unreadable] patients (intervention). An important empirical-methodological advantage of the project is the[unreadable] objective measurement of CPAP adherence, which is measured by internal microprocessor as the[unreadable] ?amount of time CPAP is used at the prescribed pressure.? This objective measurement allows[unreadable] feedback of treatment adherence and efficacy to both patient and provider, and we have designed[unreadable] the i-PAP intervention around this central feature.[unreadable] Because it is well-known that adherence patterns are established very early in treatment, i-PAP is[unreadable] designed to provide new CPAP users with education and support they require to get started on[unreadable] CPAP: The Learning Center provides education about OSA and CPAP; the interactive[unreadable] Troubleshooting Guide helps the patients troubleshoot and solve CPAP problems; My Charts[unreadable] allows graphical representation not only of treatment adherence data, but treatment efficacy data[unreadable] as well; My Journal allows the journaling of the patient?s experiences; My Assessments allow the[unreadable] patients to enter their own data and track their progress on a number of measures; My Message[unreadable] Board facilitates timely interactions with sleep providers (and in the future other OSA patients).[unreadable] Essentially, i-PAP is designed to provide the care that patients want and need, at the time they[unreadable] want and need it. The overarching aim of the present project is to examine the effect of this patientcentered,[unreadable] collaborative care ?internet intervention? on increasing CPAP adherence to a clinically[unreadable] meaningful level and to examine the potential mediators of this effect. The central questions that[unreadable] encompass the conceptual and empirical contours of the study: Does the i-PAP intervention have[unreadable] an effect on the patient?s experience of care, CPAP adherence, and OSA outcomes relative to[unreadable] usual care, and if so, what are the possible mechanisms that account for the effect?[unreadable]