title: The effect of physician continuing medical education on patient-reported outcomes for identifying and optimally managing obstructive sleep apnea.
abstract: OBJECTIVE
  To evaluate the effect of continuing medical education (CME) activities on patient reported outcomes with regard to (1) screening for excessive sleepiness (ES) and obstructive sleep apnea (OSA) and (2) appropriate referral and treatment.
  
  
  METHODS
  A total of 725 patients were recruited from 75 providers who either participated or did not participate in Transtheoretical Model (TTM)-based OSA CME activities. Patient reported outcomes from participating (n = 36) and non-participating providers (n = 39) were compared using generalized estimating equations examining random effects of provider as unit of assignment.
  
  
  RESULTS
  Patients' reports demonstrate that participating physicians were 1.7 times more likely to initiate discussion of sleep problems than non-participating physicians (t1,411 = 3.71, p = 0.05) and 2.25-2.86 times more likely to administer validated measures for OSA (Epworth Sleepiness Scale and STOP-BANG). Patient reports also indicated that participating clinicians (79.9%) were significantly more likely to recommend seeing a sleep specialist compared to non-participating clinicians (60.7%; t1,348 = 9.1, p < 0.01, OR = 2.6). Furthermore, while 89.4% of participating clinicians recommended a sleep study, only 73.2% of the non-participating physicians recommended one (t1,363 = 11.46, p < 0.001, OR = 3.1).
  
  
  CONCLUSIONS
  Participation in TTM-based OSA CME activities was associated with improved patient reported outcomes compared to the non-participating clinicians.
authors.forename: Sara S
authors.initials: SS
authors.lastname: Johnson
authors.forename: Patricia H
authors.initials: PH
authors.lastname: Castle
authors.forename: Deborah
authors.initials: D
authors.lastname: Van Marter
authors.forename: Anne
authors.initials: A
authors.lastname: Roc
authors.forename: David
authors.initials: D
authors.lastname: Neubauer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence / Q000706:statistics & numerical data; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
keywords: behavior; continuing medical education; obstructive sleep apnea; patient-reported outcomes
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