Grant: Project Grant

Over 6% of Canadians have obstructive sleep apnea (OSA), a disease in which individuals do not breathe normally because of airway narrowing or collapse during sleep. People with OSA are at increased risk of motor vehicle collisions, cardiovascular disease and lower quality of life compared to the general population. The complications of untreated OSA are also costly to the healthcare system. The diagnosis and treatment of OSA usually involves patient referral by a primary care doctor to a sleep specialist, which can lead to very long wait times for care. Research studies have shown that primary care doctors can provide high quality care for patients with OSA. However, there are many barriers preventing primary care doctors from managing OSA effectively. In 2018, an online clinical care pathway was created to help Calgary primary care doctors to diagnose and treat most patients with OSA, and to identify more complex patients who should be referred to a specialist. In this study, we will determine if the pathway has achieved this goal. We have three aims: 1) Measure visits to the pathway website and the number and characteristics of patients who are referred to sleep doctors before and after the pathway was launched. This information will help us describe how the pathway is being used and how it affects decisions that primary care doctors make about referring patients with OSA to specialists 2) Survey and interview primary care doctors to determine whether they find the pathway useful and how it could be improved 3) Enhance the pathway based on this feedback and re-evaluate its use and referrals from primary care doctors to determine if the enhanced pathway achieves its goal Our results will improve the use of the pathway by primary care doctors, to help them diagnose and treat most patients with OSA without specialist referral. We will also increase the understanding of how clinical care pathways can be used to improve patient care for other conditions.