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Implementation and feasibility of an interdisciplinary pediatric positive airway pressure adaptation program in a
Ila Linares1, Jeane Xavier1, Caroline Borginho1
1Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Insights
This study introduces an interdisciplinary program to enhance positive airway pressure (PAP) adherence in children with obstructive sleep apnea (OSA). The program aims to improve treatment outcomes and inform public health policy for pediatric sleep apnea management.
Area of Science:
- Pediatric Sleep Medicine
- Public Health
- Implementation Science
Background:
- Early diagnosis and treatment of pediatric obstructive sleep apnea (OSA) are crucial for academic, cognitive, and social development.
- Positive airway pressure (PAP) therapy is effective but often limited by poor patient adherence.
- Adaptation and engagement programs are essential to improve outcomes in pediatric OSA patients.
Purpose of the Study:
- To describe an interdisciplinary program designed to improve PAP adherence in children with OSA within Brazil's public health system.
- To assess the program's feasibility, acceptability, fidelity, and scalability using implementation science frameworks.
- To inform sustainable clinical practices and public policy for pediatric OSA management.
Main Methods:
- The program is adapted from the Children's Hospital of Philadelphia's CPAP Program.
- A prospective study involving pediatric patients (1-18 years) diagnosed with OSA requiring PAP treatment.
- Outcome measures include follow-up visit rates, time to first follow-up, patient questionnaires, and objective device data.
Main Results:
- The program is anticipated to offer integrated clinical services.
- Expected outcomes include optimized PAP adaptation, increased adherence rates, and reduced healthcare costs associated with untreated OSA.
Conclusions:
- The interdisciplinary program shows promise for improving PAP adherence in pediatric OSA patients.
- Successful implementation can lead to better patient outcomes and more efficient healthcare delivery.
- Findings will guide the development of sustainable public health policies for pediatric sleep apnea.
Introduction:
The early diagnosis and treatment of pediatric obstructive sleep apnea (OSA) can improve academic performance of affected children, in addition to enhancing their cognitive and social development. Since the effective use of positive airway pressure (PAP) is limited by difficulties in adherence to the device, adaptation and engagement programs may improve outcomes in pediatric patients.
Objective:
The aim of this study is to describe an interdisciplinary program to improve PAP adherence among children with OSA in Brazil's public health system, also assessing its feasibility, acceptability, fidelity, and scalability based on implementation science frameworks, with the goal of informing sustainable clinical practice and public policy.
Method:
The program is based on the CPAP Program developed and implemented by the Children's Hospital of the Philadelphia Sleep Center. This prospective study will involve patients aged 1 year to 18 years treated at the children's sleep clinic who have a diagnosis of OSA and indication for PAP treatment. The main outcome measures will include (1) percentage of patients who return for a follow-up visit within 4 months of treatment initiation, (2) the median number of days from the initial visit to the first follow-up visit, (3) task analysis questionnaire, (4) objective data obtained from the device's memory card.
Conclusion:
The program proposed is expected to provide an integrated clinical service, optimizing the time of adaptation to PAP, increasing adherence rates, and reducing the costs associated with medical problems of untreated OSA.
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