Primary care versus specialist sleep center management of obstructive sleep apnea and daytime sleepiness and quality of life: a randomised trial
Chai-Coetzer, Ching Li
Antic, Nicholas Alexander
Rowland, L Sharn
Reed, Richard Lewis
Esterman, Adrian Jeffrey
Catcheside, Peter G
Eckermann, Simon Douglas
Dunn, Sandra Victoria
McEvoy, Ronald Douglas
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Due to rising demand for sleep services, there has been growing interest in ambulatory models of care for obstructive sleep apnea (OSA). With appropriate training and simplified management tools, primary care physicians (PCPs) are ideally positioned to take on a greater role in the diagnosis and treatment of OSA. Objective: To compare the clinical efficacy and cost-effectiveness of a simplified model of diagnosis and care for OSA in primary care relative to that in specialist sleep centres. Design: A randomised, controlled, non-inferiority study. Setting: Primary care practices in metropolitan Adelaide and 3 rural regions of South Australia and a university hospital sleep medicine centre in Adelaide, Australia. Patients: A total of 155 patients with OSA (identified by screening questionnaire and home oximetry) and Epworth Sleepiness Scale (ESS) ≥8 or resistant hypertension were randomised into the study between September 2008 to June 2010. 81 patients were randomly assigned to the primary care arm and 74 patients to the specialist arm.
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