Abstract
The purpose of this project was to improve the obstructive sleep apnea (OSA) screening process at a family practice clinic by implementing a standard screening tool for use in a group of at-risk patients, specifically, males between the ages of forty-five and sixty-five. OSA is a highly underdiagnosed disease. Undiagnosed disease has been estimated to cost the healthcare system $34 to $69 billion annually. Untreated disease leads to adverse health outcomes. The treatment standard is continuous positive airway pressure (CPAP). Males between the ages of 45 and 65 who visited a private clinic for wellness or routine evaluation were included in the project. The city's population is nearly 50,000, with approximately 66% white, 29% Hispanic, and 2.4% black. The STOP-Bang screening questionnaire was implemented over 3 months by three primary care providers. The number of low, intermediate, and high-risk screens was recorded. The number of patients who received education, diagnostic testing, and a diagnosis of OSA and those currently receiving treatment was recorded. Ninety-two patients were screened for OSA (N=92). The mean age of the sample was 58.4 years. Over ninety-six percent of patients were white. Nineteen were high risk and 26 received education. Eight patients were referred for diagnostic testing, of which five completed the testing. Two patients were ultimately diagnosed with OSA and are receiving CPAP therapy. According to staff interviews, the STOP-Bang was simple to implement, interpret and act upon. The providers have not agreed to continue regularly using the STOP-Bang tool, however consider it a good tool if needed. A gap in the follow up process was identified after project implementation and provided an opportunity for a process improvement regarding patient follow up for ordered tests.