Increasing Identification of Risk for Obstructive Sleep Apnea in Adults with Obesity by Utilizing the STOP-Bang Questionnaire in Primary Care
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Obstructive sleep apnea (OSA) is a chronic medical disorder underrecognized, underreported, underdiagnosed, and undertreated. Untreated OSA is associated with numerous physical and mental conditions, reduced quality of life, and increased healthcare utilization. As the prevalence of OSA is rising in parallel with the increasing prevalence of obesity, this sleep-breathing disturbance is recognized as a public health concern. The purpose of this quasi-experimental evidence-based improvement project was to evaluate the clinical utility of screening adults seen in the primary care setting with a body mass index of ≥ 30 kg/m2 with the STOP-Bang questionnaire (SBQ) to increase the number of patients identified at risk for OSA and referrals to diagnostic polysomnography (PSG). Over 15 days, 36 patients with obesity presented to a rural primary care clinic and were screened with the SBQ constituting as the intervention group. Their demographics, OSA risk level, and SBQ score were recorded, as well as if the provider entered a referral to PSG if their SBQ score was greater than or equal to three. The same data was collected on a pre-intervention baseline group of 77 patients with obesity undergoing no standardized risk screening recruited over 15 days via retrospective chart review. The demographics of the two groups were found to be statistically similar. When using the SBQ, the results showed patients’ OSA risk levels were identified, and the provider increased the frequency of referrals for intermediate and high-risk patients from 4% to 52%. Because OSA represents a significant public health issue, earlier identification of this disorder is necessary to prevent the increased risk to individuals’ health.
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