|Retrospective Comparison of Traditional Face to Face Clinical Physiologist Led Consultant Supervised PAP Review Clinic and Clinical Physiologist Led Consultant Supervised Virtual PAP Review Clinic
|A.Bukhari, K.McEvoy, L.Stewarts, A.McGowan, , J. Faul,L.Cormican
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|A retrospective study of 423 patients divided as 248 followed traditional Face to Face Clinic and 175 patients followed by Virtual Clinic between November 2016 and April 2021.
The COVID 19 pandemic forced changes in the delivery of our PAP service for OSA patients.
A new Virtual Clinic service is delivered by Clinical Physiologist, Supervised by Consultant, in which the patient is contacted virtually, assessed and advised by the Clinical Physiologist, then subsequently individually reviewed with the supervising Consultant. The traditional clinic was a face to face review by the Clinical Physiologist then subsequently individually reviewed with the supervising Consultant.
Compliance and Adherence were the primary outcome of this study.
ESS on treatment, number of patients seen in clinic was the secondary outcome.
The demographic of the two groups were comparable including BMI, ESS, STOP/BANG Score, Neck Circumference, Waist to Hip Ratio.
There were minor non significant differences were seen in Mallampati Score, AHI, PLM index, Arousal Index, RDI and severity of OSA.
We found that patients followed up in the Virtual Clinic had better compliance and adherence.
The ESS on treatment was also better in the Virtual clinic group ( 6.08 v 3.44 / 24 ).
Total number of patients seen per clinic was similar in both groups ( 10 ) with multiple advantages including optimal utilisation of staff time and expertise.
Virtual Clinic are at least non inferior to traditional Face to face Clinic in the follow up of patients on PAP for OSA. They may actually be better.
We recommend that all PAP review clinics should transform into Clinical Physiologist Led Consultant Supervised Virtual Clinics.