BACKGROUND: Prior studies have reported that patients with epilepsy have a higher prevalence of obstructive sleep apnea (OSA) that contributes to poor seizure control. Detection and treatment of OSA can improve seizure control in some patients with epilepsy. In this study, we sought to develop, implement, and evaluate the effectiveness of an electronic health record (EHR) alert to screen for OSA in patients with epilepsy. METHODS: A 3-month retrospective chart review was conducted of all patients with epilepsy >18 years of age who were evaluated in our epilepsy clinics prior to the intervention. An assessment for obstructive sleep apnea (AOSA) consisting of 12 recognized risk factors for OSA was subsequently developed and embedded in the EHR. The AOSA was utilized for a 3-month period. Patients identified with 2 or more risk factors were referred for polysomnography. A comparison was made to determine if there was a difference in the number of patients at risk for OSA detected and referred for polysomnography with and without an EHR alert to screen for OSA. RESULTS: There was a significant increase in OSA patient recognition. Prior to the EHR alert, 25/346 (7.23%) patients with epilepsy were referred for a polysomnography. Postintervention, 405/414 patients were screened using an EHR alert for AOSA and 134/405 (33.1%) were referred for polysomnography (p < 0.001). CONCLUSION: An intervention with AOSA cued in the EHR demonstrated markedly improved identification of epilepsy patients at risk for OSA and referral for polysomnography.
BACKGROUND: Prior studies have reported that patients with epilepsy have a higher prevalence of obstructive sleep apnea (OSA) that contributes to poor seizure control. Detection and treatment of OSA can improve seizure control in some patients with epilepsy. In this study, we sought to develop, implement, and evaluate the effectiveness of an electronic health record (EHR) alert to screen for OSA in patients with epilepsy. METHODS: A 3-month retrospective chart review was conducted of all patients with epilepsy >18 years of age who were evaluated in our epilepsy clinics prior to the intervention. An assessment for obstructive sleep apnea (AOSA) consisting of 12 recognized risk factors for OSA was subsequently developed and embedded in the EHR. The AOSA was utilized for a 3-month period. Patients identified with 2 or more risk factors were referred for polysomnography. A comparison was made to determine if there was a difference in the number of patients at risk for OSA detected and referred for polysomnography with and without an EHR alert to screen for OSA. RESULTS: There was a significant increase in OSA patient recognition. Prior to the EHR alert, 25/346 (7.23%) patients with epilepsy were referred for a polysomnography. Postintervention, 405/414 patients were screened using an EHR alert for AOSA and 134/405 (33.1%) were referred for polysomnography (p < 0.001). CONCLUSION: An intervention with AOSA cued in the EHR demonstrated markedly improved identification of epilepsy patients at risk for OSA and referral for polysomnography.
Authors: Nathan B Fountain; Paul C Van Ness; Amy Bennett; John Absher; Anup D Patel; Kevin N Sheth; David S Gloss; Diego A Morita; Mona Stecker Journal: Neurology Date: 2015-04-07 Impact factor: 9.910
Authors: R Nisha Aurora; Nancy A Collop; Ofer Jacobowitz; Sherene M Thomas; Stuart F Quan; Amy J Aronsky Journal: J Clin Sleep Med Date: 2015-03-15 Impact factor: 4.062
Authors: Frances Chung; Stavros G Memtsoudis; Satya Krishna Ramachandran; Mahesh Nagappa; Mathias Opperer; Crispiana Cozowicz; Sara Patrawala; David Lam; Anjana Kumar; Girish P Joshi; John Fleetham; Najib Ayas; Nancy Collop; Anthony G Doufas; Matthias Eikermann; Marina Englesakis; Bhargavi Gali; Peter Gay; Adrian V Hernandez; Roop Kaw; Eric J Kezirian; Atul Malhotra; Babak Mokhlesi; Sairam Parthasarathy; Tracey Stierer; Frank Wappler; David R Hillman; Dennis Auckley Journal: Anesth Analg Date: 2016-08 Impact factor: 5.108
Authors: Demetrius M Maraganore; Thomas Freedom; Kelly Claire Simon; Lori E Lovitz; Camelia Musleh; Richard Munson; Nabeela Nasir; Smita Patel; Joya Paul; Mari Viola-Saltzman; Steven Meyers; Richard Chesis; Laura Hillman; Samuel Tideman; Anna Pham; Rosa Maria Vazquez; Roberta Frigerio Journal: Sleep Sci Pract Date: 2020-01-02