Introduction With a 2% increase in sleep referrals and impact from COVID-19, a safer and more effective way of working was required. Historically CPAP is issued face-to-face (F2F), DTCC was introduced to increase patient capacity. The aim is to compare compliance and efficacy between DTCC and F2F appointments.
Method Between 12/11/20 & 18/3/21 N=58 (44♂ & 14♀) patients with confirmed Obstructive Sleep Apnoea (OSA) attended DTCC. Average Oxygen Desaturation Index (ODI) 15.45 (4.47-46), age 52.1yrs (29-86), BMI 31.92 (21-55), Mean SpO2 93.81% (81.68-96.69). Prior to DTCC patients watched demonstration video, paperwork was completed and machines pre-assigned. 10 minute appointment, patients were consented to AirView, mask size measured and post CPAP questionnaire plus brief instructions were given. First review at ~4 weeks, (use of ≥ 4 hrs/p/n.1 Weaver, TE) indicated compliance. Post ESS obtained and absolute Δ in ESS calculated to identify clinical outcomes. Data was analysis using Microsoft Excel.
Results Compliance of 50% was achieved, N=29 (22♂ 7♀), 29 patients either returned the machine, did not use or were non-compliant; (22♂ & 7♀). ESS reduced by 5.36 (50.93%), however only 35 post CPAP questionnaires/ESS were returned. Average time for F2F appointment (~45 mins.) compared to DTCC (~15 mins.). (Table 1).
Discussion DTCC shows small reduction in compliance when compared to 61% from data previous local study.2 Therefore DTCC is a time efficient alternative to F2F appointments with average reduction of ~30 minutes per patient. The DTCC will aid recovery post COVID, allowing increased outpatient capacity while reducing footfall.
Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy, proceedings of the american thoracic society 2008;5:173–178.
EJ Oakham, M Unstead, AD McGown. CPAP compliance and symptomatic benefit: a comparison of patients established on CPAP from GP or preoperative screening. Thorax 2017;2018:A1–A220.
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