0566 Utilizing a Triage Tool Questionnaire to Identify PAP-Related Issues in Patients Newly-Initiated on Therapy for OSA

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Abstract Introduction Developing strategies to enhance Positive Airway Pressure (PAP) adherence is crucial for improving outcomes in patients with obstructive sleep apnea (OSA). We introduce a novel Triage Tool (TT) questionnaire designed to identify specific usage challenges to facilitate targeted interventions. Methods Moderate-severe OSA (AHI≥15) patients newly-initiated on PAP therapy (AutoCPAP, ResMed) were enrolled (Kaiser Permanente, Fontana, CA). A digital platform (Somnoware, Inc.) emailed patients a link to the electronic TT questionnaire at 5, 10, and 30 days post-treatment initiation. The 31-item TT is comprised of 6 domains: Adverse Effects, Pressure, Mask/Device, Disturbed Sleep, Psycho-social, and Unintentional. A Likert scale (1 – 4) was used where ‘1 = not at all’ and ‘4 = a lot’ in response to “how much does this issue bother you?” We characterized the frequency of issues in the overall group and between adherent (Adh) and non-adherent (NA) subgroups (adherent: ≥70% usage, ≥4 hours over 30 days), using descriptive statistics. Results Of 150 enrolled patients (age 48±14; male 58%; AHI 41.1±21.1), 73 were Adh and 77 were NA. Overall TT response rate was 57% (63, 60, 50%, respectively, at day 5, 10, 30) and higher for Adh than NA (70.3% ± 5.0 vs 45.9% ± 6.7) Average number of patient endorsed issues (i.e., responses scored 3 or 4) was higher for NA than Adh and decreased over time – day 5: 4.1 ± 4.2 vs 3.4 ± 4.1; day 10: 3.9 ± 5.4 vs 2.8 ± 3.6; day 30: 2.5 ± 5.4 vs 2.2 ± 3.6. Commonly endorsed issues were: dry throat/mouth (21%), waking too early (20%), mask discomfort (19%), nasal congestion (18%), and difficulty initiating sleep (16%). NA patients additionally endorsed difficulty falling (23%) and staying (19%) asleep, waking with mask off (19%) and embarrassment (23%) or concern about appearance (23%). Adh patients more frequently concerned about traveling with PAP (20%). Conclusion The TT questionnaire identified “mask/device” discomfort and “adverse effects” as commonly endorsed problems among newly-treated OSA patients. NA patients also reported “disturbed sleep” and “psychosocial” barriers. Identifying specific treatment-related problems experienced by individuals may guide targeted interventions. Further psychometric evaluation is underway to refine the TT questionnaire. Support (if any)

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