Abstract
BackgroundCommunity pharmacies may potentially assist in screening for chronic conditions such as sleep disorders, which remain both under-diagnosed and untreated. We aimed to compare a subjective risk-assessment-only questionnaire (RAO) for common sleep disorder screening against the same risk-assessment questionnaire plus a nasal flow monitor as an objective marker of possible underlying obstructive sleep apnea (OSA) (RA+) in a community pharmacy setting. The primary outcome was the number of participants identified in RAO or RA+ group who were likely to have and consequently be diagnosed with OSA. Further outcomes included the number of participants identified as being at risk for, referred for, taking-up referral for, and then diagnosed with OSA, insomnia, and/or restless legs syndrome (RLS) in either group.MethodsIn a cluster-randomized trial, participants were recruited through 23 community pharmacies. Using validated instruments, 325 (RAO = 152, RA+ = 173) participants were screened for OSA, insomnia, and RLS.Findings218 (67%) participants were at risk of OSA, insomnia or RLS and these participants were referred to their primary physician. The proportion of screened participants identified as being at risk of OSA was significantly higher in the RA+ group (36% in RAO vs. 66% in RA+, OR 3.4, 95% CI (1.8–6.5), p<0.001). A 12-month follow-up was completed in 125 RAO and 155 RA+ participants. Actual referral uptake was 34% RAO, 26% RA+, OR 4.4, 95% CI (1.4–19.2), p = 0.31. The OSA diagnosis rate was higher in the RA+ arm (p = 0.01). To yield a single additional confirmed OSA diagnosis, 16 people would need to be screened using the RA+ protocol.ConclusionsThese results demonstrate that utilising either screening method is feasible in identifying individuals in the community pharmacy setting who are likely to have OSA, insomnia and/or RLS. Secondly, adding an objective marker of OSA to a questionnaire-based prediction tool resulted in more confirmed OSA diagnoses.Trial Registration: ACTR.org.au ACTRN12608000628347
Highlights
Sleep disorders remain both under-diagnosed and untreated despite being highly prevalent and imposing substantial burden in the developed world [1,2]
These results demonstrate that utilising either screening method is feasible in identifying individuals in the community pharmacy setting who are likely to have obstructive sleep apnea (OSA), insomnia and/or restless legs syndrome (RLS)
Adding an objective marker of OSA to a questionnaire-based prediction tool resulted in more confirmed OSA diagnoses
Summary
Sleep disorders remain both under-diagnosed and untreated despite being highly prevalent and imposing substantial burden in the developed world [1,2]. Common sleep disorders affecting Australians comprise obstructive sleep apnea (OSA) (4.7%), primary insomnia (3%), and restless legs syndrome (RLS) (1.2%) [2]. Sleep disorders are commonly associated with other major medical problems [3,4] and present more frequently in the primary health care population. Sleep disturbances, such as those caused by obstructive sleep apnea (OSA) and insomnia, are associated with increased likelihood of cardiovascular disease, diminished quality of life, and increased all-cause mortality risk, and are considered one of the top 10 potentially modifiable cardiovascular disease risk factors [1,5,6,7,8]. Further outcomes included the number of participants identified as being at risk for, referred for, taking-up referral for, and diagnosed with OSA, insomnia, and/or restless legs syndrome (RLS) in either group
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
