title: Effectiveness of intervention led by a community pharmacist for improving recognition of sleep apnea in primary care--a cohort study.
abstract: Despite its high prevalence and major public health ramifications, obstructive sleep apnea syndrome (OSAS) remains underdiagnosed. The aim of this study was to determine whether the involvement of a community pharmacist (CP) in the care pathway of a patient at risk of OSAS, through the implementation of a community pharmacist (CP) intervention, was effective, i.e. increased the use of diagnostic tests in this population. We compared a cohort of patients included in a research protocol (exposed to a CP intervention) with patients having the same characteristics taken from a general population database who did not receive the intervention (unexposed group). The aim of the CP intervention was to educate patients about the risk of untreated OSAS, encouraging them to consult their general practitioner, and urging the doctor to continue investigations. We included 782 patients at risk of OSAS, i.e. taking one or more anti-hypertensive drugs, being overweight (body mass index >25) and snoring almost every night (88 in the exposed group and 694 in the unexposed group). After a 6-month follow-up, the number of patients who underwent an OSAS diagnostic test was significantly higher in the exposed group compared to the unexposed group (22.7 versus 11.4%, P = 0.003). Being exposed to the pharmacist intervention was associated with a higher chance of undergoing a diagnostic test for OSAS, adjusted odds ratio: 2.24 (1.25-4.01). In conclusion, these findings provide arguments for the implementation of a CP OSAS screening intervention in CP routine practice.
authors.affiliation: Centre de Recherche Médecine, Sciences, Santé, Santé Mentale, Société (CERMES3) INSERM U 988, Villejuif, France.
authors.forename: Clémence
authors.initials: C
authors.lastname: Perraudin
authors.forename: Bernard
authors.initials: B
authors.lastname: Fleury
authors.forename: Nathalie
authors.initials: N
authors.lastname: Pelletier-Fleury
mesh_terms: D015992:Body Mass Index; D015331:Cohort Studies; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D004198:Disease Susceptibility; D005260:Female; D005602:France; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D050177:Overweight / Q000150:complications; D010595:Pharmacists; D011320:Primary Health Care / Q000379:methods*; D011336:Probability; D024382:Professional Role; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis*; D012913:Snoring / Q000150:complications; D000078329:Workforce
keywords: apnea; pharmacy; screening