title: The Victorian CPAP program: is there a need for additional education and support?
abstract: BACKGROUND
  The Victorian Continuous Positive Airways Pressure (CPAP) Program provides CPAP services to financially disadvantaged individuals with moderate to severe sleep apnoea.
  
  
  OBJECTIVE
  To evaluate health outcomes in patients referred to the pilot program in order to: (i) assess the magnitude of health benefit from treatment in this highly selected population and (ii) identify patient characteristics or factors related to service provision that may influence outcome.
  
  
  METHODS
  We adopted a simple before-after research design. Patients who were referred to the program were recruited from five sleep centres. Questionnaires were administered at baseline and 1 and 3 months after commencing CPAP. Generic and disease-specific quality of life were assessed using the MOS 36-Item Short-form Health Survey and the Sleep Apnoea Quality-of-life Index, respectively. Subjective daytime sleepiness was measured using the Epworth Sleepiness Scale and the Sleep-Wake Activity Inventory.
  
  
  RESULTS
  Of the 68 subjects enrolled in the study, 59 were available for follow up. There were significant improvements in daytime sleepiness (P < 0.0005). Treatment-related symptoms had a negative impact on overall disease-specific quality of life, however there were significant improvements in all other domains of disease-specific quality of life (P < 0.0005). Improvements in generic quality of life were small but statistically significant (P < 0.05). Hospital, disease severity, baseline sleepiness, gender and CPAP-machine type were not predictors of outcome (P > 0.05).
  
  
  CONCLUSIONS
  This review of the Victorian CPAP Program identified significant improvements in subjective daytime sleepiness and quality of life, despite the negative impact of treatment-related symptoms. Future research should explore whether services can be modified to help reduce the impact of treatment-related side-effects.
authors.affiliation: Clinical Epidemiology and Health Service Evaluation Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia. ManserRL@mh.org.au
authors.forename: R L
authors.initials: RL
authors.lastname: Manser
authors.forename: M T
authors.initials: MT
authors.lastname: Naughton
authors.forename: R J
authors.initials: RJ
authors.lastname: Pierce
authors.forename: A
authors.initials: A
authors.lastname: Sasse
authors.forename: H
authors.initials: H
authors.lastname: Teichtahl
authors.forename: M
authors.initials: M
authors.lastname: Ho
authors.forename: D A
authors.initials: DA
authors.lastname: Campbell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000009:adverse effects; D011446:Prospective Studies; D011788:Quality of Life; D012891:Sleep Apnea Syndromes / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014739:Victoria