The Victorian CPAP Program: is there a need for additional education and support?

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Abstract:

Abstract Background

: The Victorian Continuous Positive Airways Pressure (CPAP) Program provides CPAP services to financially disadvantaged individ­uals with moderate to severe sleep apnoea. Aims

: To evaluate health outcomes in patients referred to the pilot program in order to: (i) assess the magnitude of health benefit from treatment in this highly selected population and (ii) identify patient characteristics or factors related to service provision that may influence outcome. Methods

: We adopted a simple before−after research design. Patients who were referred to the program were recruited from five sleep centres. Questionnaires were administered at baseline and 1 and 3 months after commencing CPAP. Generic and disease-­specific quality of life were assessed using the MOS 36-Item Short-form Health Survey and the Sleep Apnoea Quality-of-life Index, respectively. Sub­jective daytime sleepiness was measured using the Epworth Sleepiness Scale and the Sleep−Wake Activity ­Inventory. Results

: Of the 68 subjects enrolled in the study, 59 were available for follow up. There were significant improvements in daytime sleepiness (P < 0.0005). Treatment-related symptoms had a negative impact on overall disease-specific quality of life, how­ever there were significant improvements in all other domains of disease-specific quality of life (P < 0.0005). Improvements in generic quality of life were small but statistically significant (P < 0.05). Hospital, disease severity, baseline sleepiness, gender and CPAP-machine type were not predictors of outcome (P > 0.05). Conclusion

: This review of the Victorian CPAP Program identified significant improvements in sub­jective daytime sleepiness and quality of life, despite the negative impact of treatment-related symptoms. Future research should explore whether services can be modified to help reduce the impact of treatment-related side-effects. (Intern Med J 2002; 32: 526−532)

Keywords: CPAP; health-services research; quality of life; sleep apnoea syndromes; subjective daytime sleepiness

Document Type: Research Article

DOI: http://dx.doi.org/10.1046/j.1445-5994.2002.00295.x

Affiliations: 1: Clinical Epidemiology and Health Service Evaluation Unit, Royal Melbourne Hospital, 2: Sleep and Ventilatory Failure Service, Alfred Hospital, 3: Respiratory Medicine, Austin and Repatriation Medical Centre, 4: Latrobe Valley Hospital, Traralgon, Victoria, Australia 5: Respiratory and Sleep Disorders Medicine, Western Hospital and 6: Monash Medical Centre, Melbourne and

Publication date: November 1, 2002

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