P52 Postal diagnostics and teleconsultation can increase attendance for investigation of sleep apnoea, with the greatest impact seen in people from areas of deprivation

Abstract

<h3></h3> We have previously shown that people from areas of high deprivation referred to the sleep clinic with possible OSA, who attend, have worse symptoms, are more obese, more often have diabetes and hypertension and have more severe OSA compared to people from areas of low deprivation.¹ They are referred at lower rates and are more likely to fail to attend (DNA). We explored the impact of postal diagnostics and tele consultations on the DNA rates in the clinic according to levels of social deprivation. To increase the accessibility of our sleep service we have trialled posting oximetry to patients and having a telephone consultation (’post/tele’). Our usual pathway has involved asking patients to collect an oximeter and attend a face-to-face appointment (F2F). We have run the 2 pathways simultaneously with in turn allocation according to capacity. We compared total DNA rates and that between quintiles of the Index of Multiple Deprivation (IMD least deprived = 5, most = 1) according to the person’s home postcode. Data were extracted from hospital records for new referrals from East of England to the clinic from May 2021 to May 2022. There were 5001 people referred who were offered 5481 appointments. The overall DNA rate was 17.9%. For the people offered F2F appointments the DNA rate was 19.8%. 996 people were offered post/tele appointments and their DNA rate was 10.9% a relative difference of 45%. The largest difference in DNA rates between the 2 pathways was for people living in areas with the highest quintile of deprivation: actual difference 15%, relative difference 52% (Chi Square P = &lt;0.0001) See figure 1. Minimising difficulties attending appointments can have a major impact on DNA rates to appointments for diagnosis of possible sleep apnoea. The largest benefit in our cohort was seen among people living in the most deprived areas. <h3>Reference</h3> Lee K, Adrienko N, Andrienko G, <i>et al</i> S129 Social deprivation appears to be a barrier to referral for investigation of obstructive sleep apnoea. <i>Thorax</i> 2021;<b>76</b>:A77.