Multicentre study on acess to treatment with CPAP in patients with sleep apnea in different cities of Latin America

• Grant number: 15/11126-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date until: September 01, 2015
• End date until: August 31, 2016
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Lia Rita Azeredo Bittencourt
• Grantee: Beatriz Chao Calixto de Jesus
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

The obstructive sleep apnea syndrome (OSAS) is highly prevalent. Patients with this condition have characteristics such as snoring, breathing pauses and excessive daytime sleepiness. Physical signs such as obesity, extended neck, small or retrognathic mandible or maxilla and a narrowed airway path suggest the diagnosis of OSAS, which is confirmed by polysomnography. After the diagnosis, the patient has some treatment options, including weight loss, airway path surgery and intraoral appliances. However, the most indicated treatment is use of CPAP (Continuous Positive Airway Pressure). Since adherence to treatment may be difficult, the patient must be closely monitored during this period. Justification: The project is part of the first multicentre and multinational study in Latin America, and, in this specific project, in outpatients from Instituto do Sono de São Paulo/ AFIP, to evaluate the accessibility and adherence to treatment with CPAP in patients with obstructive sleep apnea, in addition to assess the influence of different factors as potential obstacles to treatment. OBJECTIVES: The purpose of the project is to evaluate the accessibility and adherence to treatment with CPAP in patients with obstructive sleep apnea attended at different cities in Latin America; but, in this project, in outpatients from Instituto do Sono de São Paulo/ AFIP. Therefore, the aim is to determine the proportion of patients who had access to CPAP within twelve months after the diagnosis of OSAS, verify the difficulties of initiating and maintaining the therapy and set a adherence rate from patients who had access to therapy. Material and methods: A cross-sectional, descriptive, multicentre and multinational study, in this specific project, outpatients from Instituto do Sono de São Paulo/ AFIP, with qualitative and quantitative approach will be realized. Data collection will be done through a telephone questionnaire to patients with apnea and hypopnea index (AHI) greater than or equal to 15 events/hour, detected in polysomnography held from 12 to 18 months prior to recruitment, selected from the data bank of each participating centre. The answers will be stored in a database and used to determine the proportion of patients who began treatment with CPAP, CPAP usage rate in the population under treatment, possible causes of noncompliance to treatment, whether there was implementation of alternative treatments, medical coverage of each patient (public or private) and the institution/reference city. Finally, the results will be statistically analyzed using the Student's t, chi-square and multiple logistic regression tests.