Enabling Sleep Apnea Patient-Centered Care Via an Internet Intervention

通过互联网干预实现以睡眠呼吸暂停患者为中心的护理

• 批准号: 7361608
• 负责人: Carl J. Stepnowsky
• 金额: $ 39.35万
• 依托单位: VETERANS MEDICAL RESEARCH FDN/SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-12 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7361608
• 关键词: Enabling; Sleep; Apnea; Patient; Centered

The objective of this proposal is to examine the effect of a novel interoperable ?internet intervention? for patients with Obstructive Sleep Apnea syndrome (OSA) that integrates a telemetry treatment device and an internet-based portal that facilitates patient-centered, collaborative management for patients prescribed the gold-standard treatment, continuous positive airway pressure (CPAP). Poor treatment adherence with CPAP therapy is well-documented. Set against a backdrop of telemedicine applications that have grown as fast in unsubstantiated claims and assumptions of patient satisfaction, diagnostic accuracy, clinical efficacy, and cost-effectiveness as they have in technological sophistication and capabilities, the evaluative aspect of this proposal is designed as a randomized, controlled clinical trial?Usual Care patients (control) versus i-PAP patients (intervention). An important empirical-methodological advantage of the project is the objective measurement of CPAP adherence, which is measured by internal microprocessor as the ?amount of time CPAP is used at the prescribed pressure.? This objective measurement allows feedback of treatment adherence and efficacy to both patient and provider, and we have designed the i-PAP intervention around this central feature. Because it is well-known that adherence patterns are established very early in treatment, i-PAP is designed to provide new CPAP users with education and support they require to get started on CPAP: The Learning Center provides education about OSA and CPAP; the interactive Troubleshooting Guide helps the patients troubleshoot and solve CPAP problems; My Charts allows graphical representation not only of treatment adherence data, but treatment efficacy data as well; My Journal allows the journaling of the patient?s experiences; My Assessments allow the patients to enter their own data and track their progress on a number of measures; My Message Board facilitates timely interactions with sleep providers (and in the future other OSA patients). Essentially, i-PAP is designed to provide the care that patients want and need, at the time they want and need it. The overarching aim of the present project is to examine the effect of this patientcentered, collaborative care ?internet intervention? on increasing CPAP adherence to a clinically meaningful level and to examine the potential mediators of this effect. The central questions that encompass the conceptual and empirical contours of the study: Does the i-PAP intervention have an effect on the patient?s experience of care, CPAP adherence, and OSA outcomes relative to usual care, and if so, what are the possible mechanisms that account for the effect?

该提案的目的是检查新颖的互联网效果吗？ 干涉？对于集成遥测的阻塞性睡眠呼吸暂停综合征（OSA）的患者 治疗设备和基于Internet的门户，可促进以患者为中心的协作 患者的管理处方了金色标准治疗，连续阳性气道 压力（CPAP）。通过CPAP治疗的治疗依从性不佳。对抗a 远程医疗应用的背景在未经证实的主张和 患者满意度，诊断准确性，临床功效和成本效益的假设 它们具有技术的复杂性和能力，该提议的评估方面是 设计为一项随机，受控的临床试验？通常的护理患者（对照）与I-PAP 患者（干预）。该项目的重要经验方法论是 CPAP依从性的客观测量，由内部微处理器衡量 在规定压力下使用的时间cpap。此客观测量允许 对患者和提供者的治疗依从性和功效的反馈，我们已经设计了 围绕此中心功能的I-PAP干预。 因为众所周知，在治疗的早期就建立了依从性模式，所以I-PAP是 旨在为新的CPAP用户提供入门所需的教育和支持 CPAP：学习中心提供有关OSA和CPAP的教育；交互式 故障排除指南可帮助患者进行故障排除和解决CPAP问题；我的图表 不仅允许图形表示治疗依从性数据，还允许治疗功效数据 也我的日记允许记录患者的经历；我的评估允许 患者输入自己的数据并在许多措施上跟踪他们的进度；我的消息 董事会促进了及时与睡眠提供者（以及将来其他OSA患者）进行互动。 本质上，I-PAP旨在提供患者想要和需要的护理，当时他们需要 想要并需要它。本项目的总体目的是检查此患者中心的效果 协作护理？互联网干预？提高CPAP依从性临床 有意义的水平并检查这种效果的潜在介体。中心问题 涵盖了研究的概念和经验轮廓：I-PAP干预是否具有 相对于患者的护理，CPAP依从性和OSA结果的影响 通常的护理，如果是这样，可以说明效果的可能机制是什么？