Obstructive Sleep Apnea Screening for Adults in Primary Care Setting

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Fleege, Lauren
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Obstructive Sleep Apnea , Primary Care , OSA
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Purpose: The purpose of this quality improvement project was to implement routine obstructive sleep apnea (OSA) screening in a family practice clinic and provide a comprehensive tool kit consisting of provider resources to help with the assessment and management of OSA. Background: Obstructive sleep apnea (OSA) is a vastly underdiagnosed issue in the United States, affecting 29.4 million people, but only 5.9 million are diagnosed. The disease is linked to a 1.9 times increased risk of all-cause mortality and a 2.65 times increased risk of cardiovascular mortality, imposing an economic burden of $149.6 billion. Early detection of OSA is crucial for improving the quality of life and preventing health complications. Screening for OSA can be done effectively in primary care settings using tools such as the STOP-Bang to assess disease risk. Sample/Setting: The setting was a private family practice clinic in Dubuque, Iowa, led by a family nurse practitioner. The sample included adults ages 18 years and older. Rigorous adherence to inclusion and exclusion criteria ensured patient selection. A total of sixty patients were screened. Methods: OSA screening was implemented utilizing the STOP-Bang tool and algorithms over a three-month period. A post-survey assessed the provider's perception and sustainability of the project. Results: 36.7% of the 60 patients who were screened qualified for diagnostic testing. Among them, 20% opted for at-home sleep studies, but only 10% completed them. Of those completing studies, 66.7% tested positive for OSA. Four patients received CPAP therapy, with one reporting significant improvement post-implementation. Follow-up appointments for the other three were not yet completed one month post-project. A post-survey by the nurse practitioner confirmed the project's usefulness and ease of implementation. Conclusion: The STOP-Bang screening tool in primary care can enhance patient outcomes and reduce the burden of untreated OSA. Effectively screening, identifying, and managing OSA in primary care settings can significantly decrease associated mortality and morbidity rates.
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