OSA follow-up: a quality improvement study
DOI:
https://doi.org/10.32385/rpmgf.v39i3.12654Keywords:
Sleep apnea, Obstructive, Noninvasive ventilation, Primary health careAbstract
Purpose: To improve the quality of the follow-up in primary health care (PHC) for patients with stabilized OSAS, by conducting an appropriate clinical evaluation.
Type of study: Quasi-experimental, pre-post-intervention.
Local: Unidade de Saúde Familiar (USF) Buarcos.
Population: Patients with a prescription for ventilolyherapy from January 7, 2016, to December 31, 2016 (1st evaluation), and from July 01, 2017, to December 31, 2017 (2nd evaluation), with a diagnosis of OSAS and hospital discharge.
Methods: Criteria: (1) annual medical consultation; (2) registration of adherence and effectiveness of ventilotherapy (reports of Home Respiratory Care (HRC)); (3) application of the Epworth Scale (ES); (4) evaluation of side effects. First evaluation and intervention in January 2017: disclosure of results; brochure for analysis of reports and ES; contact with HRC companies. Second evaluation: January 2018. The effectiveness of the intervention would translate into an increase in the registration of the criteria for adherence and efficacy, the application and registration of ES, and the evaluation of the side effects. It was defined as a goal, in one year, 90% for the first criterion, and 40% for each of the remaining criteria.
Results: After the intervention, there was an increase of 12% (p=0.0773) in the simultaneous fulfillment of all criteria, with a statistically significant increase in 2nd criterion (from 14% to 58%, p=0.0002).
Conclusions: After the intervention, there was an overall improvement in the follow-up of patients: in 12% all the criteria were met; despite not being statistically significant, it contrasts with the first evaluation in which no patient was properly monitored. Ventilotherapy is effective and the methods for assessing adherence and effectiveness are simple. This study intends to start continuous work in this pathology with a great impact on morbidity and mortality, but still far from the main health indicators of PHC.
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