https://doi.org/10.4081/monaldi.2023.2673

Comparison among three different follow-up models for obstructive sleep apnea syndrome patients: focus on the physiotherapist’s role

Early Access
Submitted: June 22, 2023
Accepted: September 28, 2023
Published: October 4, 2023
OSAS, CPAP, sleep apnea disorders, rehabilitation
Abstract Views: 520
PDF_early view: 286
Supplementary: 28
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Authors

Carla Simonelli
https://orcid.org/0000-0003-2238-7499
Cardio-Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Lumezzane (BS), Italy.
Michele Vitacca
https://orcid.org/0000-0002-9389-7915
Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Lumezzane (BS), Italy.
Beatrice Salvi
https://orcid.org/0000-0001-7203-4320
Cardio-Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Lumezzane (BS), Italy.
Manuela Saleri
Cardio-Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Lumezzane (BS), Italy.
Mara Paneroni
mara.paneroni@icsmaugeri.it
https://orcid.org/0000-0003-3982-2098
Cardio-Respiratory Rehabilitation, ICS Maugeri IRCCS, Institute of Lumezzane (BS), Italy.

In obstructive sleep apnea syndrome (OSAS) subjects different follow-up modalities have been proposed to improve adherence to the continuous positive airway pressure (CPAP) device. This retrospective study compares three different health professional approaches dedicated to caring OSAS patients in three consecutive follow-up periods of 15 months each. The three different follow-up models are: i) physician-oriented follow-up (P-F); ii) physiotherapist-oriented follow-up (PT-F); and iii) tele-titration plus PT-oriented follow-up (TT-PT-F). Health personal visits and actions delivered, patients' adherence, CPAP efficacy, and problems under CPAP use were considered for comparison. Data from 122 OSAS patients with a new prescription of CPAP were analyzed: 39 (32.0%) in the P-F, 38 (31.1%) in the PT-F, and 45 (36.9%) in the TT-PT-F period. We found a reduction over time (from 40.9% in P-F to 8.2% in TT-PT-F, p<0.001) in patients missing the 1-year follow-up visit. The PT-F and TT-PT-F lead to a reduction in physician visits in comparison to P-F (5.2% and 8.9% vs 100%, p<0.001) with no differences in time to the first follow-up visit, CPAP efficacy, and patients’ adherence among the three periods. More device-related problems were found in the PT-F (57.8%), compared with the PF (25.6%) period (p<0.001); the most common troubles were mask problems evaluated in 26.2% of cases. In conclusion, different follow-up models offer similar efficacy and short-term adherence for CPAP leading to a significant reduction in physician visits under the PT-F with or without tele-titration, being mask problems as the most commonly treated. Further analysis should be useful to define the best cost-efficacy follow-up intervention.

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Ethics approval

The study was approved by the Institutional Review Board of Istituti Clinici Scientifici (ICS) Maugeri

How to Cite

Simonelli, Carla, Michele Vitacca, Beatrice Salvi, Manuela Saleri, and Mara Paneroni. 2023. “Comparison Among Three Different Follow-up Models for Obstructive Sleep Apnea Syndrome Patients: Focus on the physiotherapist’s Role”. Monaldi Archives for Chest Disease, October. https://doi.org/10.4081/monaldi.2023.2673.
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