LA Net Advisory
Council Members
John A Kotick, JD (Chairman)
Family Health Care Centers of Greater Los Angeles
Mohsen Bazargan, Ph.D.
Charles R. Drew University of Medicine and Science
Condessa Curley, MD
Eisner Pediatrics and Family Medical Center
Ignacio DeArtola , MD
Cleaver Family Wellness Center
Grace Floutsis, MD
Clinica Msr. Oscar A. Romero
Lillian Gelberg, MD, MSPH
University of California, Los Angeles
Ricardo G. Hahn, MD
University of Southern California
Sally Hur, Pharm. D.
QueensCare, Echo Park
Sarah Ingersoll, MSN, MBA, RN
American Medical Informatics Association
University of Southern California
Cristina Jose Kampher, PhD
AltaMed
June Levine. RN, MSN
Access to Care Collaborative
Carmela Lomonaco, PhD
Imelda Meza, MA
The Children’s Clinic
Kiki Nocella, PhD
Felix Nuñez, MD, MPH
Community Clinic Association of Los Angeles County
Elise Pomerance, MD
East Valley Community Health Center
Jehni Robinson, MD
The Los Angeles Free Clinic
Michael A. Rodríguez, MD, MPH
University of California, Los Angeles
Richard Seidman, MD, MPH
LA Care
Maureen Strohm, MD
California Hospital Medical Center
Ava Lenda Waldman
AIDS Research Alliance
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Obstructive Sleep Apnea
Management of Obstructive Sleep Apnea by Primary Care Providers
Obstructive sleep apnea (OSA) is a sleep disturbance characterized by intermittent, partial or complete upper airway closure, resulting in episodes of hypopnea and apnea. The cost of medical care for patients wtih OSA and its consequences are probably large, and appropriate treatement could probably cut these costs in half. Several studies have found that mean annual medical costs adn physician claims incurred by patients during the ten years prior to the diagnosis of OSA were more than twice as high for age, gender and BMI-matched controls without OSA.
There is, however, a woeful lack of information about how patients with OSA are recognized, evaluated and managed in primary care settings. It is estimated the 2-4% of U.S. adults have OSA, but less than 25% are identified and diagnosed. The prevalence of OSA appears to rise with increasing age, reaching at least 7% of among adults over age 65.
While we won't be able to fill in all of the gaps in our knowledge, this project will be able to answer many questions about screening, diagnostic evaluation and management in primary care settings.
LA Net is very excited to be one of five PBRNs piloting this study.
Participating PBRNs:
Information for Participating Clinics
WHAT IS THE LA NET OSA STUDY?
LA Net and a consortium of other organizations across the US have been funded by the Agency of Healthcare Research and Quality (AHRQ) to study the management of Obstructive Sleep Apnea (OSA) by primary care clinicians. The principle aim of this study is to identify barriers and facilitators primary care clinicians encounter in caring for patients with OSA. The information generated by this study will assist AHRQ to develop strategies to improve OSA management in primary health care settings across the country, and will also be made available to your practice and clinicians through an on-site training at the conclusion of the study.
WHY STUDY OSA?
Obstructive sleep apnea (OSA), a sleep disturbance characterized by intermittent, partial or complete upper airway closure, can significantly increase the costs of caring for a patient. It is estimated the 2-4% of U.S. adults have OSA with prevalence increasing with age to at least 7% of the population by age 65. It is estimated that fewer than 25% of these patients are actually identified and diagnosed.
Recent studies have found that medical costs incurred by patients in the 10 years prior to their diagnosis with OSA were double those of matched controls (BMI, age, gender) without OSA. Timely diagnosis and treatment of OSA can significantly reduce medical costs associated with these patients. However, the health care community has very little information concerning actual practices related to detection, treatment and management of these patients. Even less is known about these processes for publicly insured and uninsured patients being cared for by safety net providers and CHCs.
WHY PARTICIPATE IN THIS STUDY?
Practices and clinicians who are selected to participate in the LA Net OSA study will have the opportunity to participate in a national study that directly informs AHRQ’s work in primary care. You and your practice will have the opportunity to become members of LA Net, to serve on the national research team if you so choose, to participate in publications that result from the study, and to receive a copy of the findings that you can use to inform practice at your own clinic. In some instances, a CME training may be able to be conducted as a way of conveying study findings to your clinic and staff.
WHAT WILL MY PRACTICE AND I BE ASKED TO DO FOR THE STUDY?
Nine clinicians and nine practices from the LA area will be selected to participate in the study. Clinicians will be asked to complete a one-hour interview with LA Net staff about OSA and their patients. Each clinician will also be asked to provide charts for up to 25 patients with OSA (based on 5 ICD9 codes) for LA Net staff to review and to provide charts for up to 25 patients aged 65 years and older. Finally, LA Net staff will conduct wait room surveys with 50 consecutive patients from your practice about OSA. LA Net will execute business agreements with each practice prior to initiating the study and IRB approval for the study will be obtained.
WHAT IS THE STUDY TIMELINE?
The study will run from December 2008 through August 2009. All LA Net staff members working with your clinic will have proper Human Subjects Certification. This study has met with IRB approval. Clinics and those who participate in key informant interviews (with clinicians) will be compensated for their time.
The study contractor is the University of Oklahoma Health Sciences Center’s PBRN, OKPRN. Other PBRNs participating include: APBRN (Alabama), ProHealth (Connecticut), and SoFla-PBRN (Florida).
Key Documents:
• LA Net Main Page
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