Assessing the Prioritization of Primary Care Referrals for Polysomnograms

Thornton, J. Daryl; Chandriani, Kinnari; Thornton, Julia Gore; Farooq, Sobia; Moallem, Moayyed; Krishnan, Vidya; Auckley, Dennis

doi:10.1093/sleep/33.9.1255

Cited by 20 publications

(14 citation statements)

References 34 publications

(24 reference statements)

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“…[23][24][25][26][27] Moreover, these studies focused on specific areas of medicine including cardiology and pulmonology. It is likely that increased awareness of OSA might have generally led to an increase in referral rates for OSA evaluation in the United States.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Referrals for Obstructive Sleep Apnea Evaluation among Community Physicians

Williams¹,

Nunes

Zizi³

et al. 2015

Journal of Clinical Sleep Medicine

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Study Objectives: This study assessed knowledge and attitudes toward obstructive sleep apnea (OSA) among community physicians and explored factors that are associated with referrals for OSA evaluation. Methods: Medical students and residents collected data from a convenience sample of 105 physicians practicing at communitybased clinics in a large metropolitan area. Average age was 48 ± 14 years; 68% were male, 70% black, 24% white, and 6% identifi ed as "other." Physicians completed the Obstructive Sleep Apnea Knowledge and Attitudes questionnaire. Results: The average year in physician practice was 18 ± 19 years. Of the sample, 90% reported providing care to black patients. The overall OSA referral rate made by physicians was 75%. OSA knowledge and attitudes scores ranged from 5 to 18 (mean = 14 ± 2) and from 7 to 20 (mean = 13 ± 3), respectively. OSA knowledge was associated with white race/ ethnicity (r p = 0.26, p < 0.05), fewer years in practice (r p = -0.38, p < 0.01), patients inquiring about OSA (r p = 0.31, p < 0.01), and number of OSA referrals made for OSA evaluation (r p = 0.30, p < 0.01). Positive attitude toward OSA was associated with patients inquiring about OSA (r p = 0.20, p < 0.05). Adjusting for OSA knowledge and attitudes showed that physicians whose patients inquired about OSA were nearly 10 times as likely to make a referral for OSA evaluation (OR = 9.38, 95% CI: 2.32-38.01, p < 0.01). Conclusion: Independent of physicians' knowledge and attitudes toward obstructive sleep apnea, the likelihood of making a referral for obstructive sleep apnea evaluation was infl uenced by whether patients inquired about the condition.

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Section: Discussionmentioning

confidence: 99%

Factors Associated with Referrals for Obstructive Sleep Apnea Evaluation among Community Physicians

Williams¹,

Nunes

Zizi³

et al. 2015

Journal of Clinical Sleep Medicine

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“…The role of primary care is to assess the patient for sleep apnea risk, provide referral for assessment and treatment by a sleep specialist, and reinforce the importance of adherence with treatment (Thornton, et al, 2010). Although it is commonly assumed that persons with OSAS fit a certain profile (i.e., male, overweight, stocky build), it cannot be assumed that persons not fitting this profile would not have OSAS.…”

Section: Obstructive Sleep Apneamentioning

confidence: 99%

Sleep Disturbances in Persons Living With HIV

Taibi

2013

Journal of the Association of Nurses in AIDS Care

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Up to 70% of persons living with HIV (PLWH) experience sleep disturbances. Insomnia and obstructive sleep apnea syndrome (OSAS) are common disorders seen in the primary care of PLWH. This paper reviews the current evidence and practice recommendations for treating these conditions. Insomnia is evaluated by clinical interview, questionnaires, and sleep diaries. The recommended first-line treatment is cognitive-behavioral therapy for insomnia (CBT-I), delivered by a trained therapist. Certain sedative medications may be useful, but over-the-counter treatments (particularly those containing antihistamines) are not recommended. OSAS is diagnosed by overnight sleep study but can be screened for in primary care. The STOP-BANG is a useful 8-item screening tool. The gold standard of treatment for OSAS is the use of a continuous positive airway pressure device. Treatment of insomnia and OSAS is important for improving quality of life and preventing associated health problems (especially cardiovascular disease in OSAS) in PLWH.

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“…BQ has also been used in bed partners to screen sleep apneic patients[ 15 ], in elderly[ 16 ], in preoperative identification in elective surgical patients[ 17 ], in coronary artery disease[ 18 ] with either portable PSG or PSG in sleep laboratories and used to get an idea of the prevalence of OSA in different groups without PSG. [ 19 20 21 ]…”

Section: Discussionmentioning

confidence: 99%