Using Telemedicine to Improve Veteran Sleep Apnea Care

NCT ID: NCT01259440

Last Updated: 2015-11-04

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

23 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-08-31

Study Completion Date

2012-05-31

Brief Summary

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Obstructive sleep apnea (OSA) is highly prevalent in the Veteran population given the risk factors of male gender, being overweight, and increasing age. OSA is caused by upper airway obstruction, resulting in arousals from sleep and hypoxia. While continuous positive airway pressure (CPAP) is a highly efficacious treatment for OSA, compliance with treatment is suboptimal. Because research shows that adherence patterns are established early in treatment, we seek to use a technology that enables early and frequent productive interactions between patient and provider.

Detailed Description

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Background:

Obstructive sleep apnea (OSA) is highly prevalent in the Veteran population given the risk factors of male gender, being overweight, and increasing age. OSA is caused by upper airway obstruction, resulting in arousals from sleep and hypoxia. While continuous positive airway pressure (CPAP) is a highly efficacious treatment for OSA, compliance with treatment is suboptimal. Because research shows that adherence patterns are established early in treatment, we seek to use a technology that enables early and frequent productive interactions between patient and provider

Objectives:

The objective of this proposal is to explore the feasibility and initially evaluate the potential efficacy of a video teleconferencing system for patients with Obstructive Sleep Apnea syndrome (OSA) that facilitates patient- centered, collaborative management for patients who are prescribed the gold-standard treatment, continuous positive airway pressure (CPAP).

Methods:

The evaluative aspect of this proposal was designed as a pilot randomized, controlled clinical trial of Video Teleconferencing (VTC) compared to Usual Care (UC). The key feature of the Video Teleconferencing intervention was the use of a telemedicine system that allows for audio/visual conferencing with the patient in their home environment from the start of treatment initialization. The provider is able provide more direct feedback to the patient based on the telemedicine interaction, and the patient benefits from increased contact with the provider. Specific inclusion and exclusion criteria included: age \> 18 years; confirmed diagnosis of moderate-severe OSA; being newly prescribed CPAP therapy; having chronic symptoms as noted on screening symptom checklist; and fluency in English. Patients were recruited from the VA San Diego Healthcare System Pulmonary Sleep Clinic. Patients were enrolled for a 2-month time period. Groups were compared on quantitative and qualitative measures.

Status:

Study Complete

Conditions

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Sleep Apnea Syndromes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Participants

Study Groups

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Video Teleconferencing Care

Video teleconferencing care

Group Type ACTIVE_COMPARATOR

Video Teleconferencing Care

Intervention Type BEHAVIORAL

The core component of the VTC intervention is the frequent contact between patient and provider using a telemedicine system that allows for audio-visual communication.

Usual Care

Usual Care

Group Type PLACEBO_COMPARATOR

Usual Care

Intervention Type BEHAVIORAL

Consists of one week telephone call and one month clinic visit

Interventions

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Video Teleconferencing Care

The core component of the VTC intervention is the frequent contact between patient and provider using a telemedicine system that allows for audio-visual communication.

Intervention Type BEHAVIORAL

Usual Care

Consists of one week telephone call and one month clinic visit

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Diagnosed with Moderate to Severe Sleep Apnea
* Live in San Diego County
* Veteran

Exclusion Criteria

* Previous use of positive pressure airway therapy
* Residence outside of San Diego county
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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VA Office of Research and Development

FED

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Carl J Stepnowsky, PhD

Role: PRINCIPAL_INVESTIGATOR

San Diego Veterans Healthcare System

Locations

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VA San Diego Healthcare System

San Diego, California, United States

Site Status

Countries

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United States

Other Identifiers

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H130392

Identifier Type: OTHER

Identifier Source: secondary_id

PPO 10-101

Identifier Type: -

Identifier Source: org_study_id

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