Eficacia y coste-efectividad del diagnóstico y decisión terapéutica de la apnea obstructiva del sueño en atención primariadescripción de la metodología.

  1. F. Javier Barca Durán 1
  2. M.A. Sánchez-Quiroga 2
  3. J. Corral Peñafiel 2
  4. F.J. Gómez de Terreros 2
  5. C. Carmona-Bernal 3
  6. A. Sánchez-Armengol 3
  7. A. Sánchez de la Torre 2
  8. J. Durán Cantolla 2
  9. C.J. Egea Santaolalla 2
  10. N. Salord 2
  11. C. Monasterio 2
  12. J. Terán 2
  13. M.L. Alonso Álvarez 2
  14. J. Muñoz Méndez
  15. E.M. Arias
  16. M. Cabello
  17. J.M. Montserrat 2
  18. M. De la Peña 2
  19. J.C. Serrano
  20. F. Barbe 2
  21. J.F. Masa
  1. 1 Universidad de Extremadura
    info

    Universidad de Extremadura

    Badajoz, España

    ROR https://ror.org/0174shg90

  2. 2 Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias
    info

    Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias

    Madrid, España

  3. 3 Hospital Universitario Virgen del Rocío
    info

    Hospital Universitario Virgen del Rocío

    Sevilla, España

    ROR https://ror.org/04vfhnm78

Erakutsi afiliazioak +
Aldizkaria:
Revista española de patología torácica

ISSN: 1889-7347

Argitalpen urtea: 2020

Alea: 32

Zenbakia: 4

Orrialdeak: 260-274

Mota: Artikulua

DIALNET GOOGLE SCHOLAR lock_openSarbide irekia editor

Beste argitalpen batzuk: Revista española de patología torácica

Laburpena

los médicos de Atención Primaria (AP) desempeñan un papel pasivo en el tratamiento del Síndrome de Apnea Obstructiva del Sueño (SAOS) La simplificación del diagnóstico y el uso de un algoritmo semiautomático para decidir el tratamiento pueden facilitar la integración de estos médicos de AP con ventajas de costo. El objetivo de este artículo fue describir el método utilizado en un ensayo controlado, aleatorizado, multicéntrico, de no inferioridad, con dos brazos paralelos y un análisis de costo-efectividad realizado en seis hospitales terciarios. Los pacientes con sospecha de SAOS se asignaron al azar al grupo de Atención Primaria (AP) o al protocolo del hospital. En AP, se utilizó un sistema de diagnóstico simplificado con análisis automático y toma de decisiones terapéuticas. El brazo intrahospitalario utilizó polisomnografía y la decisión terapéutica especializada. La variable principal fue la escala de somnolencia de Epworth y la secundaria, la adherencia a CPAP y los costos, entre otros.

Erreferentzia bibliografikoak

  • Durán J, Esnaola S, Rubio R, Iztueta A. Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med. 2001; 163: 685-9.
  • Ballester E, Badia JR, Hernández L et al. Evidence of the effectiveness of Continuous Positive Airway Pressure in the Treatment of Sleep Apnea/Hypopnea Syndrome. Am J Respir Crit Care Med 1999; 159: 495-501.
  • Marin JM, Carrizo SJ, Vicente E et al. Longterm cardiovascular outcomes in men with obstructive sleep apnea-hypopnea with or whitout treatment with continuous positive airway pressure: an observational study. Lancet 2005; 365(9.464): 1.046-53.
  • Barbé F, Durán-Cantolla J, Sánchez de la Torre M et al. Spanish Sleep and Breathing Network. Effect of continuous positive airway pressure on the incidence of hypertesion and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial. JAMA 2012, May 23; 307: 2.161-8.
  • Terán-Santos J, Jiménez-Gómez A, CorderoGuevara J. The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med 1999; 340: 847-51.
  • Masa JF, Rubio M, Findley LJ. Habitually sleepy drivers have a high frequency of automobile crashes associated with respiratory disorders during sleep. Am J Respir Crit Care Med 2000; 162: 1.407-12.
  • Masa JF, Corral J, Pereira R et al. Effectiveness of home respiratory polygraphy for the diagnosis of sleep apnea and hypopnea syndrome. Thorax. 2011 Jul; 66(7): 567-73.
  • Flemons WW, Littner MR, Rowley JA et al. Home diagnosis of sleep apnea: systematic review of the literature. An evidence reiew cosponsored by the American Academy of Sleep Medicine, the American College of Chest Physicians, and the American Thoracic Society. Chest. 2003; 124: 1.543-79.
  • Collop NA, Anderson WM, Boehlecke B et al. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2007; 3: 737-47.
  • Wong KHK, Jankelson D, Reid A et al. Diagnostic Test evaluation of a nasal flow monitor for obstructive sleep apnea detection in sleep apnea research. Behavior Research Methods 2008; 40: 360-366.
  • Ragette R, Wang Y, Weinreich G, Teschler H. Diagnostic performance of single airflow channel recording (ApneaLink) in home diagnosis of sleep apnea. Sleep Breath. 2010 Jun; 14(2): 109-14.
  • Masa JF, Duran-Cantolla J, Capote F et al. Efficacy of home single-channel nasal pressure for recommending continuous positive airway pressure treatment in sleep apnea. Sleep 2015; 38: 13–21.
  • Watkins MR, Talmage JB, Thiese MS et al. Correlation between screening for obstructive sleep apnea using a portable device versus polysomnography testing in a comercial driving population. J Occup Environ Med. 2009; 51: 1.145-50.
  • Erman MK, Stewart D, Einhorn D et al. Validation of the ApneaLink for the screening of sleep apnea: a novel and simple singlechannel recording device. J Clin Sleep Med. 2007 Jun 15; 3(4): 387-92.
  • Rofail LM, Wong KK, Unger G et al. The utility of single-channel nasal airflow pressure transducer in the diagnosis of OSA at home. Sleep. 2010 Aug; 33(8): 1.097-105.
  • Oktay B, Rice TB, Atwood CW Jr et al. Evaluation of a single-channel portable monitor for the diagnosis of obstructive sleep apnea. J Clin Sleep Med. 2011 Aug 15; 7(4): 384-90.
  • Masa JF, Corral J, Pereira R et al. Therapeutic decision-making for sleep apnea and hypopnea syndrome using home respiratory polygraphy: a large multicentric study. Am J Respir Crit Care Med. 2011 Oct 15; 184(8): 964-71.
  • Masa JF, Duran-Cantolla J, Capote F et al. Efficacy of Home Single-Channel Nasal Pressure for recommending CPAP treatment in Sleep Apnea.
  • Chai-Coetzer CL, Antic NA, Rowland LS et al. Primary care vs specialist sleep center management of obstructive sleep apnea and daytime sleepiness and quality of life: a randomized trial. JAMA. 2013 Mar 13; 309(10): 997-1.004.
  • Collop NA, Anderson WM, Boehlecke B et al. Portable Monitoring Task Force of the American Academy of Sleep Medicine. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2007; 3: 737–747.
  • Sánchez-Quiroga MÁ, Corral J, Gómez-deTerreros FJ et al. Primary Care Physicians Can Comprehensively Manage Sleep Apnea Patients: A Non-inferiority Randomized Controlled Trial. Am J Respir Crit Care Med. 2018.
  • Lloberes P, Durán-Cantolla J, MartínezGarcía MA et al. Diagnosis and treatment of sleep apnea–hypopnea syndrome. Arch Bronconeumol 2011; 47: 143–156.
  • Iber C, Ancoli-Israel S, Chesson AL et al. The AASM manual of scoring of sleep and associated events. Rules, terminology and technical specifications 2007. Westchester, IL: American Academy of Sleep Medicine; 2007.
  • Masa JF, Jiménez A, Durán J et al. Alternative methods of titrating continuous positive airway pressure: a large multicenter study. Am J Respir Crit Care Med 2004; 170: 1.218-24.
  • Masa JF, Corral J, Pereira R J et al. Therapeutic decision-making for sleep apnea and hypopnea syndrome using home respiratory polygraphy: a large multicentric study. Am J Respir Crit Care Med 2011; 184: 964–71.
  • Andreu AL, Chiner E, Sancho-Chust JN et al. Effect of an ambulatory diagnostic and treatment programme in patients with sleep apnoea. Eur Respir J 2012; 39: 305-312.
  • Masa JF, Corral J, Sanchez de Cos J et al. Effectiveness of three sleep apnea management alternatives. Sleep 2013; 36: 1.799–1.807.
Datuen iturria: Dialnet