TY - JOUR
T1 - The firstly visited department affects the acceptance of CPAP in patients with obstructive sleep apnea
T2 - a cohort study
AU - Wu, Chung Sheng
AU - Chen, David Hsin Kuang
AU - Ko, Yuan Chun
AU - Bai, Chyi Huey
AU - Chen, Po Yueh
AU - Liu, Wen Te
AU - Lin, Yi Chih
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Background: Continuous positive airway pressure (CPAP) therapy is the first-line treatment for obstructive sleep apnea (OSA). However, the low acceptance rate of CPAP remains a challenging clinical issue. This study aimed to determine the factors that influence the acceptance rate of CPAP. Methods: This retrospective cohort study was conducted at the sleep center of Shuang-Ho Hospital. Initially, 1186 OSA patients who received CPAP therapy between December 2013 and December 2017 were selected, and finally, 1016 patients were analyzed. All patients with OSA received CPAP therapy for at least 1 week, and their acceptance to treatment was subsequently recorded. Outcome measures included patients’ demographic and clinical characteristics (sex, age, BMI, comorbidities, history of smoking, and the medical specialist who prescribed CPAP treatment), polysomnography (PSG) results, and OSA surgical records. Results: Patients with a lower CPAP acceptance rate were referred from otolaryngologists (acceptance rate of otolaryngology vs. others: 49.6% vs. 56.6%, p =.015), in addition to having a lower apnea–hypopnea index (AHI) (acceptance vs. non-acceptance: 55.83 vs. 40.79, p =.003), rapid eye movement AHI (REM-AHI) (acceptance vs. non-acceptance: 51.21 vs. 44.92, p =.014), and arousal index (acceptance vs. non-acceptance: 36.80 vs. 28.75, p =.011). The multiple logistic regression model showed that patients referred from otolaryngology had a lower CPAP acceptance rate (odds ratio 0.707, p =.0216) even after adjusting for age, sex, BMI, AHI, REM-AHI, arousal index, comorbidities, and smoking status. Conclusions: Before their initial consultation, patients may already have their preferred treatment of choice, which is strongly linked to the type of medical specialists they visit, and consequently, affects their rate of acceptance to CPAP therapy. Therefore, physicians should provide personalized care to patients by exploring and abiding by their preferred treatment choices.
AB - Background: Continuous positive airway pressure (CPAP) therapy is the first-line treatment for obstructive sleep apnea (OSA). However, the low acceptance rate of CPAP remains a challenging clinical issue. This study aimed to determine the factors that influence the acceptance rate of CPAP. Methods: This retrospective cohort study was conducted at the sleep center of Shuang-Ho Hospital. Initially, 1186 OSA patients who received CPAP therapy between December 2013 and December 2017 were selected, and finally, 1016 patients were analyzed. All patients with OSA received CPAP therapy for at least 1 week, and their acceptance to treatment was subsequently recorded. Outcome measures included patients’ demographic and clinical characteristics (sex, age, BMI, comorbidities, history of smoking, and the medical specialist who prescribed CPAP treatment), polysomnography (PSG) results, and OSA surgical records. Results: Patients with a lower CPAP acceptance rate were referred from otolaryngologists (acceptance rate of otolaryngology vs. others: 49.6% vs. 56.6%, p =.015), in addition to having a lower apnea–hypopnea index (AHI) (acceptance vs. non-acceptance: 55.83 vs. 40.79, p =.003), rapid eye movement AHI (REM-AHI) (acceptance vs. non-acceptance: 51.21 vs. 44.92, p =.014), and arousal index (acceptance vs. non-acceptance: 36.80 vs. 28.75, p =.011). The multiple logistic regression model showed that patients referred from otolaryngology had a lower CPAP acceptance rate (odds ratio 0.707, p =.0216) even after adjusting for age, sex, BMI, AHI, REM-AHI, arousal index, comorbidities, and smoking status. Conclusions: Before their initial consultation, patients may already have their preferred treatment of choice, which is strongly linked to the type of medical specialists they visit, and consequently, affects their rate of acceptance to CPAP therapy. Therefore, physicians should provide personalized care to patients by exploring and abiding by their preferred treatment choices.
KW - Acceptance
KW - Continuous positive airway pressure
KW - Obstructive sleep apnea
KW - Shared decision making
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U2 - 10.1186/s40463-023-00676-z
DO - 10.1186/s40463-023-00676-z
M3 - Article
C2 - 37898803
AN - SCOPUS:85175144655
SN - 1916-0208
VL - 52
JO - Journal of Otolaryngology - Head and Neck Surgery
JF - Journal of Otolaryngology - Head and Neck Surgery
IS - 1
M1 - 71
ER -