To the Editor In patients screened for moderate to severe OSA, Dr Chai-Coetzer and colleagues1 reported that management in a primary care setting was statistically noninferior to a specialist sleep center setting regarding change in subjective sleepiness measured by the Epworth Sleepiness Scale (ESS). There are several aspects of this study that we think should be highlighted.
Study withdrawal was 2- to 3-fold higher in the primary care vs sleep specialist groups, with almost half of the withdrawals in the primary care group due to CPAP intolerance. No patients in the sleep specialist group withdrew due to CPAP intolerance. The expertise of the sleep medicine specialist in improving CPAP adherence as well as adherence-related outcomes is well known.2 Also unexplained in the article is how shifting management from the sleep specialist to the primary care clinician would “… improve patient access to sleep services” or result in care “… delivered at a lower cost.”
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.