Quality of follow-up of patients with obstructive sleep apnea syndrome in a family health unit: pre-post intervention study
DOI:
https://doi.org/10.32385/rpmgf.v40i3.13547Keywords:
Primary care, Quality improvement, Sleep apnea, ObstructiveAbstract
Background: Patients with obstructive sleep apnea syndrome (OSAS), undergoing treatment with continuous positive airway pressure (CPAP), after discharge from the hospital consultation, should maintain follow-up in primary health care, for therapeutic monitoring.
Objectives: To improve the follow-up of patients with OSAS with CPAP and without sleep medicine consultation follow-up, in a Family Health Unit (FHU). Secondary outcome: number of hospital referrals due to ineffective therapy.
Methods: Quasi-experimental, pre- and post-intervention study; in a FHU. Patients diagnosed with “Perturbação do Sono” (P06 – ICPC2), with OSAS, undergoing treatment with CPAP, and without Sleep Medicine Consultation follow-up were included. Data from the clinical process related to the follow-up consultations, CPAP device data report (DDR), and hospital referrals were analyzed. A first evaluation was carried out in 2019 (January-December). Subsequently, clinical sessions at the FHU for the multidisciplinary team and an action procedure to request DDR by the administrative team were made. Pocket-sized memory aids were provided. A computer folder was shared with the user follow-up guide, a model document for DDR requests, and a pamphlet on OSAS. The second evaluation focused on January-December 2021. After discussion at a medical meeting, the defined outcomes were a rate of follow-up appointments ≥20% and a DDR interpretation rate ≥20%.
Results: It was found that no patient had an adequate follow-up in the first evaluation. In 2021, a DDR interpretation rate of 25.47% and a follow-up appointment rate of 15.09% were reached. Five hospital referrals were made for ineffective therapy.
Conclusion: Although the goal set for follow-up consultations was not reached, this study promoted the involvement of the entire team and the implementation of a simple strategy for OSAS follow-up in the primary healthcare setting.
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