PT  - JOURNAL ARTICLE
AU  - Supriya K. Jambhekar
AU  - Gulnur Com
AU  - Xinyu Tang
AU  - Kristi K Pruss
AU  - Rithea Jackson
AU  - Charles Bower
AU  - John L. Carroll
AU  - Wendy Ward
TI  - Role of a Respiratory Therapist in improving adherence with positive airway pressure treatment in a Pediatric Sleep Apnea Clinic
AID  - 10.4187/respcare.02312
DP  - 2013 Jun 12
TA  - Respiratory Care
PG  - respcare.02312
4099  - http://rc.rcjournal.com/content/early/2013/06/13/respcare.02312.short
4100  - http://rc.rcjournal.com/content/early/2013/06/13/respcare.02312.full
AB  - Background: Many pediatric patients need positive airway pressure (PAP) for treatment of obstructive sleep disordered breathing (OSDB). Adherence with use of PAP equipment (defined as percent of nights with nightly use of PAP for more than 4 hours) is often poor and not sustained long- term. With any chronic disease, education has been shown to help with patient outcomes. Education of patients and parents regarding PAP use can be provided by different health care professionals. There is no published literature assessing role of respiratory therapists in improving adherence with PAP in children. We hypothesize that addition of respiratory therapist (RT) visits to a PAP clinic helps in improving adherence. Methods: RT services for PAP patients were introduced in a multidisciplinary sleep clinic. We identified children who had been followed in clinic and had adherence download information before and after introduction of RT services. We collected information regarding demographic data, polysomnogram details and CPAP adherence at clinic visits. Results: Forty six patients met criteria for inclusion. The mean age was 14.6 years ( SD 6). The mean apnea hypopnea index was 26.7/hr (SD 30). Other than addition of RT intervention, all patients continued to receive the same clinical services as before. Patients were divided into 3 groups based on baseline adherence: 0% use, use for 1-50% nights, use for >50% nights. There was a statistically significant improvement in use of PAP in patients with baseline use of 0% and 1-50% but no improvement in those with >50% baseline use. There was no significant change in PAP use at subsequent RT visits. Conclusion: Utilization at clinic visits of a respiratory therapist trained in the use of PAP improves adherence in pediatric patients with OSDB when their baseline PAP adherence rate is less than 50%.