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. 2018 Dec;8(6):468-471.
doi: 10.1212/CPJ.0000000000000502.

Electronic health record cue identifies epilepsy patients at risk for obstructive sleep apnea

Martha A Mulvey  1 , Aravindhan Veerapandiyan  1 , David A Marks  1 , Xue Ming  1
Affiliations

Electronic health record cue identifies epilepsy patients at risk for obstructive sleep apnea

Martha A Mulvey et al. Neurol Clin Pract. 2018 Dec.

Abstract

Background: Prior studies have reported that patients with epilepsy have a higher prevalence of obstructive sleep apnea (OSA) that contributes to poor seizure control. Detection and treatment of OSA can improve seizure control in some patients with epilepsy. In this study, we sought to develop, implement, and evaluate the effectiveness of an electronic health record (EHR) alert to screen for OSA in patients with epilepsy.

Methods: A 3-month retrospective chart review was conducted of all patients with epilepsy >18 years of age who were evaluated in our epilepsy clinics prior to the intervention. An assessment for obstructive sleep apnea (AOSA) consisting of 12 recognized risk factors for OSA was subsequently developed and embedded in the EHR. The AOSA was utilized for a 3-month period. Patients identified with 2 or more risk factors were referred for polysomnography. A comparison was made to determine if there was a difference in the number of patients at risk for OSA detected and referred for polysomnography with and without an EHR alert to screen for OSA.

Results: There was a significant increase in OSA patient recognition. Prior to the EHR alert, 25/346 (7.23%) patients with epilepsy were referred for a polysomnography. Postintervention, 405/414 patients were screened using an EHR alert for AOSA and 134/405 (33.1%) were referred for polysomnography (p < 0.001).

Conclusion: An intervention with AOSA cued in the EHR demonstrated markedly improved identification of epilepsy patients at risk for OSA and referral for polysomnography.

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Figures

Figure
Figure. Assessment of obstructive sleep apnea (AOSA) in the electronic health record
© 2018 Epic Systems Corporation. Used with permission.
See this image and copyright information in PMC

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