Telemedicine for regional sleep patients – Translating sleep services closer to home - TRENCH Pilot Study Protocol

Poor sleep affects up to 45% of Australians and regional patients are further disadvantaged in accessing sleep services for diagnosis and management. This is particularly relevant in Queensland, where 36% of the state’s population reside outside of metropolitan areas. This twelve-month Hybrid Type I implementation pilot project will implement a telehealth-led, delivered and governed, local sleep service pathway encompassing screening, diagnosis, treatment and on-going management for patients with suspected sleep disorders in Rockhampton. This major regional centre has no existing public diagnostic and treatment sleep service; therefore service delivery will be managed and overseen by the existing Respiratory and Sleep Investigations Unit of the Royal Brisbane and Women’s Hospital in Brisbane, Australia, located 637 km away. The aim of this study is to evaluate the feasibility, acceptability and implementation success of a telehealth-led model of care that delivers sleep services closer to home for regional patients. The study adopts a Hybrid Type I effectiveness-implementation design, with implementation success assessed using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance). Primary outcomes will evaluate implementation success through assessment of patient and service reach, implementation fidelity, service adoption, stakeholder acceptability and the potential sustainability of the model. Secondary outcomes will evaluate service and patient-level effectiveness, including successful completion of diagnostic testing, treatment initiation, reduction in travel requirements, and longer-term adherence to prescribed therapies. This model is designed to provide a sustainable sleep service that reduces patient barriers to receiving expert, tertiary level sleep care while affording improved service efficiency, cost-effective service delivery, optimal patient satisfaction and improved health outcomes.