Abstract
Background Obstructive sleep apnoea (OSA) is a common and treatable chronic condition that is associated with significant morbidity and economic cost. Geography is increasingly being recognised as a barrier to diagnosis and treatment of many chronic diseases; however, no study to date has investigated the impact of place of residence on health outcomes in OSA.
Objective The purpose of this study is to determine whether treatment outcomes for patients initiating continuous positive airway pressure (CPAP) for OSA differ between those who live in urban versus rural settings.
Methods A prospective cohort design will be used. Participants will be recruited through community-based CPAP providers and assigned to either the rural or urban cohort based on residential postal code. The primary outcome will be the difference in nightly hours of CPAP use between the two groups, measured 3 months after initiation of therapy. Secondary outcomes will include symptoms, quality of life, patient satisfaction and patient-borne costs.
Anticipated results This study will determine whether there are differences in CPAP adherence or patient-reported outcomes between rural and urban patients with OSA. These results will highlight potential challenges with providing OSA care in rural populations and may inform health interventions to reduce urban–rural inequities.
Abstract
Do obstructive sleep apnoea treatment outcomes differ between rural and urban populations? Engagement of community providers enables a novel approach to real-world evaluation. #sleep @ERSpublications https://bit.ly/3cGps6X
Footnotes
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Author contributions: J. Corrigan conceived and designed the study, analysed and interpreted the data, and drafted and made critical revisions to the manuscript; I. Ogah conceived and designed the study, and drafted and made critical revisions to the manuscript; A. Ip-Buting acquired data and made critical revisions to the manuscript; H. Sharpe and C.R. Laratta made critical revisions to the manuscript; P. Peller acquired data (PCCF+, SAS, Beyond 2020) and made critical revisions to the manuscript; W.H. Tsai and S.R. Pendharkar conceived and designed the study, analysed and interpreted the data, and drafted and made critical revisions to the manuscript.
Conflict of interest: J. Corrigan has nothing to disclose.
Conflict of interest: I. Ogah has nothing to disclose.
Conflict of interest: A. Ip-Buting reports grants from The Lung Association and the Respiratory Health Strategic Clinical Network during the conduct of the study.
Conflict of interest: H. Sharpe has nothing to disclose.
Conflict of interest: C.R. Laratta reports personal fees from the RANA Respiratory Care Group for the renumeration of home sleep apnoea tests outside the submitted work.
Conflict of interest: P. Peller has nothing to disclose.
Conflict of interest: W.H. Tsai has nothing to disclose.
Conflict of interest: S.R. Pendharkar has nothing to disclose.
Support statement: This study was supported by The Lung Association, Alberta and Northwest Territories National Grant Review/Grant-In-Aid Program, an Innovation and Seed Grant awarded by Alberta Health Services’ Respiratory Health Strategic Clinical Network (RHSCN), and by an RHSCN summer studentship. Funding agencies had no role in study design, analysis or interpretation of results. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received March 22, 2020.
- Accepted June 3, 2020.
- Copyright ©ERS 2020
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