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Using Telemedicine to Improve Veteran Sleep Apnea Care

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VA Office of Research and Development

Status and phase

Completed
Phase 2
Phase 1

Conditions

Sleep Apnea Syndromes

Treatments

Behavioral: Video Teleconferencing Care
Behavioral: Usual Care

Study type

Interventional

Funder types

Other U.S. Federal agency

Identifiers

NCT01259440
PPO 10-101
H130392 (Other Identifier)

Details and patient eligibility

About

Obstructive sleep apnea (OSA) is highly prevalent in the Veteran population given the risk factors of male gender, being overweight, and increasing age. OSA is caused by upper airway obstruction, resulting in arousals from sleep and hypoxia. While continuous positive airway pressure (CPAP) is a highly efficacious treatment for OSA, compliance with treatment is suboptimal. Because research shows that adherence patterns are established early in treatment, we seek to use a technology that enables early and frequent productive interactions between patient and provider.

Full description

Background:

Obstructive sleep apnea (OSA) is highly prevalent in the Veteran population given the risk factors of male gender, being overweight, and increasing age. OSA is caused by upper airway obstruction, resulting in arousals from sleep and hypoxia. While continuous positive airway pressure (CPAP) is a highly efficacious treatment for OSA, compliance with treatment is suboptimal. Because research shows that adherence patterns are established early in treatment, we seek to use a technology that enables early and frequent productive interactions between patient and provider

Objectives:

The objective of this proposal is to explore the feasibility and initially evaluate the potential efficacy of a video teleconferencing system for patients with Obstructive Sleep Apnea syndrome (OSA) that facilitates patient- centered, collaborative management for patients who are prescribed the gold-standard treatment, continuous positive airway pressure (CPAP).

Methods:

The evaluative aspect of this proposal was designed as a pilot randomized, controlled clinical trial of Video Teleconferencing (VTC) compared to Usual Care (UC). The key feature of the Video Teleconferencing intervention was the use of a telemedicine system that allows for audio/visual conferencing with the patient in their home environment from the start of treatment initialization. The provider is able provide more direct feedback to the patient based on the telemedicine interaction, and the patient benefits from increased contact with the provider. Specific inclusion and exclusion criteria included: age > 18 years; confirmed diagnosis of moderate-severe OSA; being newly prescribed CPAP therapy; having chronic symptoms as noted on screening symptom checklist; and fluency in English. Patients were recruited from the VA San Diego Healthcare System Pulmonary Sleep Clinic. Patients were enrolled for a 2-month time period. Groups were compared on quantitative and qualitative measures.

Status:

Study Complete

Enrollment

23 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Diagnosed with Moderate to Severe Sleep Apnea
  • Live in San Diego County
  • Veteran

Exclusion criteria

  • Previous use of positive pressure airway therapy
  • Residence outside of San Diego county

Trial design

Primary purpose

Supportive Care

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

23 participants in 2 patient groups, including a placebo group

Video Teleconferencing Care
Active Comparator group
Description:
Video teleconferencing care
Treatment:
Behavioral: Video Teleconferencing Care
Usual Care
Placebo Comparator group
Description:
Usual Care
Treatment:
Behavioral: Usual Care

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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