对阻塞性睡眠呼吸暂停综合征患者的三种不同后续模型进行比较:重点关注理疗师的角色
Carla Simonelli1, Michele Vitacca2, Beatrice Salvi1
1Cardio-Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Lumezzane (BS).
概括
使用持续正气道压力 (CPAP) 的阻塞性睡眠呼吸暂停综合征 (OSAS) 患者的不同后续模型显示出类似的疗效. 物理治疗师领导的随访,有或没有远程定位,显著减少了医生访问.
科学领域:
- 肺病学和睡眠医学 睡眠医学
- 医疗器械的坚持策略 医疗器械的坚持策略
- 医疗保健管理的管理
背景情况:
- 阻塞性睡眠呼吸暂停综合征 (OSAS) 管理通常需要长期坚持持续的正气道压力 (CPAP) 治疗.
- 优化患者的随访对于改善CPAP设备的坚持和治疗结果至关重要.
- 有各种由医疗保健专业人员领导的随访模式存在,但它们的比较有效性需要进一步调查.
研究的目的:
- 为了比较使用CPAP的OSAS患者的三个不同的随访模型的有效性.
- 评估以医生为导向 (P-F),以理疗师为导向 (PT-F) 和以理疗师为导向 (TT-PT-F) 的医生导向 (P-F),理疗师导向 (PT-F) 和理疗师导向 (TT-PT-F) 随访对患者坚持治疗,CPAP疗效和医疗资源利用的影响.
- 确定最有效的后续策略来管理在CPAP治疗中的OSAS患者.
主要方法:
- 对122名OSAS患者的数据进行了回顾性分析,这些患者最近被处方CPAP.
- 三个连续15个月的随访期的比较,每个采用不同的模型:P-F,PT-F和TT-PT-F.
- 评估医疗人员的访问,患者的坚持,CPAP的有效性,以及与设备相关的问题.
主要成果:
- 在随访模型中观察到,患者错过1年的随访次数显著减少 (40.9%在P-F,8.2%在TT-PT-F,p<0.001).
- 与P-F相比,以理疗师为导向的随访 (PT-F和TT-PT-F) 导致医生访问大幅减少 (8.9%和5.2%与100%相比,p<0.001).
- 在这三种模型中,在时间到第一次随访,CPAP疗效或患者坚持期间没有发现显著差异;然而,与设备相关的问题,特别是面具问题,在PT-F组中更为频繁 (57.8%).
结论:
- 在OSAS患者中,CPAP治疗的不同后续模型显示了可比的短期疗效和坚持.
- 以理疗师为导向的随访,有或没有远程定位,有效地减少了对医生访问的需求.
- 与口罩相关的问题是最常见的设备问题,需要有针对性的管理策略;建议进一步进行成本效益分析.
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