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. 2020 Oct 5;6(4):00141-2020.
doi: 10.1183/23120541.00141-2020. eCollection 2020 Oct.

An evaluation of rural-urban disparities in treatment outcomes for obstructive sleep apnoea: study protocol for a prospective cohort study

Jennifer Corrigan  1 , Imhokhai Ogah  1 , Ada Ip-Buting  2 , Heather Sharpe  2 , Cheryl R Laratta  3 , Peter Peller  4 , Willis H Tsai  1   5 , Sachin R Pendharkar  1   5
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An evaluation of rural-urban disparities in treatment outcomes for obstructive sleep apnoea: study protocol for a prospective cohort study

Jennifer Corrigan et al. ERJ Open Res. .

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.

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Conflict of interest statement

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.

Figures

FIGURE 1
FIGURE 1
Study design flow diagram: recruitment and data collection. RHCP: respiratory homecare provider; CPAP: continuous positive airway pressure.
FIGURE 2
FIGURE 2
Obstructive sleep apnoea (OSA) care pathways. Pathway 1: community (primary care physician)-based diagnostic and treatment pathway. Pathway 2: sleep facility (BC/BE sleep physician)-based diagnostic and treatment pathway. PCP: primary care physician; BC/BE: board-certified/board eligible sleep physician; HSAT: home sleep apnoea test; PSG: polysomnography; CPAP: continuous positive airway pressure.
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