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Despite significant medical sequelae of obstructive sleep apnea (OSA), the condition remains undiagnosed and untreated in many affected individuals. We explored the feasibility of a comprehensive, telemedicine-based OSA management pathway in a community-based Veteran cohort. This prospective, parallel-group randomized pilot study assessed feasibility of a telemedicine-based pathway for OSA evaluation and management in comparison to a more traditional, in-person care model. The study included 60 Veterans at the Philadelphia Veterans Affairs Medical Center and two affiliated community-based outpatient clinics. Telemedicine pathway feasibility, acceptability, and outcomes were assessed through a variety of quantitative (Functional Outcomes of Sleep Questionnaire, dropout rates, positive airway pressure PAP adherence rates, participant satisfaction ratings) and qualitative (verbal feedback) metrics. There was no significant difference in functional outcome changes, patient satisfaction, dropout rates, or objectively measured PAP adherence between groups after 3 months of treatment. Telemedicine participants showed greater improvement in mental health scores, and their feedback was overwhelmingly positive. Our pilot study suggests that telemedicine-based management of OSA patients is feasible in terms of patient functional outcomes and overall satisfaction with care. Future studies should include larger populations to further elucidate these findings while assessing provider- and patient-related cost effectiveness. Limited access to sleep medicine care is a growing concern within the Veterans Affairs (VA) healthcare system and beyond. Although various telemedicine-based modalities show promise in addressing this need, technological advancement has outpaced evidence-based implementation. Our pilot study is the first to compare prospectively a novel, telemedicine-based obstructive sleep apnea (OSA) management pathway with in-person care. Through quantitative and qualitative indices, we demonstrated no significant inter-pathway difference in participant functional outcomes or satisfaction rates following three months of treatment. These findings lay the groundwork for future sleep telemedicine research and clinical pathway development as this nascent field evolves.
Fields et al. (Mon,) studied this question.