Achieving adherence to positive airway pressure in commercial drivers using an employer-mandated remote management programme
Background Obstructive sleep apnoea (OSA) is common in commercial drivers, and associated with increased risk of crashes if untreated, making diagnosis and effective treatment crucial in this population. Study design and methods This is a retrospective summary of a clinical programme based on teleme...
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| Format: | Article |
| Language: | English |
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European Respiratory Society
2024-12-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/10/6/00132-2024.full |
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| _version_ | 1841537070371176448 |
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| author | Elizabeth Kneeland Nadia Ali David G. Maislin Yoon Hee Chang Joyce Epelboim Brendan T. Keenan Allan I. Pack |
| author_facet | Elizabeth Kneeland Nadia Ali David G. Maislin Yoon Hee Chang Joyce Epelboim Brendan T. Keenan Allan I. Pack |
| author_sort | Elizabeth Kneeland |
| collection | DOAJ |
| description | Background
Obstructive sleep apnoea (OSA) is common in commercial drivers, and associated with increased risk of crashes if untreated, making diagnosis and effective treatment crucial in this population.
Study design and methods
This is a retrospective summary of a clinical programme based on telemedicine and remote treatment monitoring developed with a national trucking company to screen new hires in the USA for OSA and implement positive airway pressure (PAP) management. New hires were informed of the programme and consented as part of their employment. Drivers who did not comply with the evaluation or with PAP after diagnosis were removed from driving commercial vehicles by the company or did not pursue further employment.
Results
A total of 975 drivers were enrolled. Among screened drivers, 35.5% were cleared without a sleep study, 15.0% were cleared following a sleep study (apnoea–hypopnoea index (AHI) <5 events·h−1), 22.1% had mild OSA (AHI 5–15) and 27.4% had moderate–severe OSA (AHI ≥15). Those with moderate–severe OSA were more obese (body mass index 36.2±6.3 kg·m−2) and had more comorbidities. Of 269 drivers starting PAP, 160 (59.5%) maintained participation in a care management programme, 80 (29.7%) resigned or were terminated, 23 (8.6%) were cleared to discontinue PAP and six (2.2%) were complex cases requiring transfer of care. Illustrating effectiveness, those that maintained participation had excellent PAP adherence (5.27±1.61 h·night−1; 88.5±12.9% days used; 79.7±17.7% days used ≥4 h).
Interpretation
Remote assessment of OSA and PAP management in commercial drivers is feasible and effective. This approach has wide-ranging applications, particularly in populations and areas with a lack of sleep medicine providers. |
| format | Article |
| id | doaj-art-14499cbcdf23457fb2c3b1dd4c776898 |
| institution | Kabale University |
| issn | 2312-0541 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj-art-14499cbcdf23457fb2c3b1dd4c7768982025-01-14T09:50:21ZengEuropean Respiratory SocietyERJ Open Research2312-05412024-12-0110610.1183/23120541.00132-202400132-2024Achieving adherence to positive airway pressure in commercial drivers using an employer-mandated remote management programmeElizabeth Kneeland0Nadia Ali1David G. Maislin2Yoon Hee Chang3Joyce Epelboim4Brendan T. Keenan5Allan I. Pack6 Kneeland Consulting, Philadelphia, PA, USA Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Background Obstructive sleep apnoea (OSA) is common in commercial drivers, and associated with increased risk of crashes if untreated, making diagnosis and effective treatment crucial in this population. Study design and methods This is a retrospective summary of a clinical programme based on telemedicine and remote treatment monitoring developed with a national trucking company to screen new hires in the USA for OSA and implement positive airway pressure (PAP) management. New hires were informed of the programme and consented as part of their employment. Drivers who did not comply with the evaluation or with PAP after diagnosis were removed from driving commercial vehicles by the company or did not pursue further employment. Results A total of 975 drivers were enrolled. Among screened drivers, 35.5% were cleared without a sleep study, 15.0% were cleared following a sleep study (apnoea–hypopnoea index (AHI) <5 events·h−1), 22.1% had mild OSA (AHI 5–15) and 27.4% had moderate–severe OSA (AHI ≥15). Those with moderate–severe OSA were more obese (body mass index 36.2±6.3 kg·m−2) and had more comorbidities. Of 269 drivers starting PAP, 160 (59.5%) maintained participation in a care management programme, 80 (29.7%) resigned or were terminated, 23 (8.6%) were cleared to discontinue PAP and six (2.2%) were complex cases requiring transfer of care. Illustrating effectiveness, those that maintained participation had excellent PAP adherence (5.27±1.61 h·night−1; 88.5±12.9% days used; 79.7±17.7% days used ≥4 h). Interpretation Remote assessment of OSA and PAP management in commercial drivers is feasible and effective. This approach has wide-ranging applications, particularly in populations and areas with a lack of sleep medicine providers.http://openres.ersjournals.com/content/10/6/00132-2024.full |
| spellingShingle | Elizabeth Kneeland Nadia Ali David G. Maislin Yoon Hee Chang Joyce Epelboim Brendan T. Keenan Allan I. Pack Achieving adherence to positive airway pressure in commercial drivers using an employer-mandated remote management programme ERJ Open Research |
| title | Achieving adherence to positive airway pressure in commercial drivers using an employer-mandated remote management programme |
| title_full | Achieving adherence to positive airway pressure in commercial drivers using an employer-mandated remote management programme |
| title_fullStr | Achieving adherence to positive airway pressure in commercial drivers using an employer-mandated remote management programme |
| title_full_unstemmed | Achieving adherence to positive airway pressure in commercial drivers using an employer-mandated remote management programme |
| title_short | Achieving adherence to positive airway pressure in commercial drivers using an employer-mandated remote management programme |
| title_sort | achieving adherence to positive airway pressure in commercial drivers using an employer mandated remote management programme |
| url | http://openres.ersjournals.com/content/10/6/00132-2024.full |
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