Nighttime-Breathing Treatments Backed by Strongest Evidence Among Options to Treat Sleep Apnea

Electronic Newsletter, Issue 322

Deaths of Americans age 18 and over hospitalized for pneumonia plummeted by 45 percent between 2000 and 2007 regardless of who paid for their care.

Deaths of Americans age 18 and over hospitalized for pneumonia plummeted by 45 percent between 2000 and 2007 regardless of who paid for their care. [Source: Agency for Healthcare Research and Quality, AHRQ State Snapshots.]

Today's Headlines

  1. Nighttime-breathing treatments backed by strongest evidence among options to treat sleep apnea
  2. New AHRQ report identifies proven design methods for use by consumer health informatics product developers
  3. AHRQ releases a Spanish-language tool to help consumers reduce medication errors
  4. New AHRQ report examines impact of human resources patterns on quality and safety
  5. AHRQ's Health Care Innovations Exchange highlights clinical and community linkages
  6. Preventive medication for gonococcal ophthalmia neonatorum: U.S. Preventive Services Task Force reaffirms recommendation statement
  7. AHRQ's National Resource Center for Health IT Web-teleconference set for August 18
  8. Registration now open for full-day HCUP Data Users' Workshop on September 15
  9. AHRQ in the professional literature

1. Nighttime-Breathing Treatments Backed by Strongest Evidence Among Options to Treat Sleep Apnea

Among the treatments for obstructive sleep apnea, the effectiveness of a nighttime-breathing machine called a "CPAP" was backed by the strongest evidence, and a mouthpiece worn at night was also shown to be effective, according to a new AHRQ-funded report. Sleep apnea is a disorder that disrupts sleep for an estimated 12 million Americans, with millions more likely undiagnosed. The report found that the continuous positive airway pressure (CPAP) machine, which pumps air through a mask while the patient is asleep, is highly effective in improving sleep and related symptoms of obstructive sleep apnea by improving airflow. Another treatment, a mouthpiece called a mandibular advancement device, can also be very effective. Weight loss and surgery may also be effective, although the evidence behind these treatments is not as strong, according to a comparative effectiveness review prepared by the Tufts Medical Center Evidence-based Practice Center for AHRQ's Effective Health Care Program. The report does note that all treatments have possible side effects. To highlight the findings of the report, AHRQ also published guides for consumers and clinicians that summarize the latest evidence for treating obstructive sleep apnea, a disorder that can lead to heart disease, diabetes, and multiple other health problems. The report and the companion guides are available on AHRQ's Effective Health Care Program Web site. The consumer guide, Treating Sleep Apnea: A Review of the Research for Adults, defines sleep apnea for patients and their families, summarizes treatment options, offers a list of questions to discuss with a doctor and contains basic cost information. The clinician guide, Comparative Effectiveness of Diagnosis and Treatment of Obstructive Sleep Apnea in Adults, covers these topics, provides "confidence ratings" for existing scientific evidence, and offers a "clinical bottom line" to give clinicians tools to discuss treatment options with their patients. Select to read our press release.

2. New AHRQ Report Identifies Proven Design Methods for Use by Consumer Health Informatics Product Developers

AHRQ released a new report that offers a range of design methods that may be applicable for developing consumer health information technology (IT) applications. Improving Consumer Health IT Application Development: Lessons from Other Industries: Background Report offers an environmental scan of design practices found in successful consumer products and identifies those that could support improved development of consumer health IT applications. The full report provides recommendations of methods that can be incorporated into consumer health IT application design processes. Select to access the report (PDF File, Plugin Software Help).

3. AHRQ Releases a Spanish-Language Tool to Help Consumers Reduce Medication Errors

AHRQ has released a revised Spanish-language medication safety booklet, Su medicamento: Infórmese. Evite riesgos (Your Medicine: Be Smart. Be Safe) to help Spanish-speaking patients learn more about how to take medicines safely. The booklet includes a detachable, wallet-size card that can help patients keep track of medicines they are taking, including vitamins and herbal and other dietary supplements. Select to download a copy of the guide in Spanish. Print copies are available by sending an E-mail to AHRQPubs@ahrq.hhs.gov. The guide is also available in English.

4. New AHRQ Report Examines Impact of Human Resources Patterns on Quality and Safety

A new AHRQ-funded report, Promoting Safety and Quality Through Human Resources Practices, examines the growing support for a link between innovative human resources staffing patterns and improvements in safety and quality in health care settings. The report features the results of five case studies conducted with health care organizations with strong reputations for human resources management based on high-performance work practices. Key findings included the importance of engaging staff with an organization's mission, vision, goals, and objectives; empowering frontline staff; hiring and placing staff based on competencies and organizational fit, rather than just on formal training; holding leaders accountable for organizational objectives; and using a high-performance organizing framework, such as Six Sigma or Lean production to clarify the link with quality and safety outcomes led by researchers at Ohio State University, the report also lays the groundwork for future research to establish a more definitive link between high-performance work practices and quality outcomes. Select to access the report and select to access a tool derived from this project, Using Workforce Practices to Guide Quality Improvement: A Guide for Hospitals.

5. AHRQ's Health Care Innovations Exchange Highlights Clinical and Community Linkages

This week's issue of the AHRQ's Health Care Innovations Exchange features two profiles of programs that increased access to culturally competent services through a comprehensive approach that included linkages. One such innovation is the Full Circle Diabetes program, which provides comprehensive care and self-management support for Native Americans with diabetes in metropolitan Minneapolis-St. Paul, MN. This program has improved participants' health-related behaviors, clinical outcomes, and emotional health. This issue also features an article about healthy weight initiatives. Select to read more innovations, tools, and articles on AHRQ's Health Care Innovations Exchange Web site.

6. Preventive Medication for Gonococcal Ophthalmia Neonatorum: U.S. Preventive Services Task Force Reaffirms Recommendation Statement

The U.S. Preventive Services Task Force has reaffirmed its 2005 recommendation that all newborns should receive topical eye medication for the prevention of gonococcal ophthalmia neonatorum within 24 hours of birth. This is a Grade A recommendation. The Task Force concluded that there was no evidence of harms associated with the treatment, and the evidence showed a clear benefit to offering the preventive measure to all newborns. Select to access the recommendation. Exit Disclaimer

7. AHRQ's National Resource Center for Health IT Web-Teleconference Set for August 18

AHRQ's National Resource Center (NRC) for Health IT will host a free 90-minute Web-based teleconference covering the unique challenges of providing care to elderly patients in hospital or nursing care home settings on August 18 at 2:30 p.m., EDT. This Web-based teleconference will present innovative ways that care is being provided to the elderly using health IT. Participants will hear from three distinguished experts: Jerry H. Gurwitz, M.D., Ph.D., Medicine Chief of the Division of Geriatric Medicine at the University of Massachusetts Medical School; Terry S. Field, D.Sc., Associate Director of the Meyers Primary Care Institute and Associate Professor at the University of Massachusetts Medical School; Kate Lapane, Ph.D., M.S., Charles and Evelyn Thomas Professor of Epidemiology and Chair of the Department of Epidemiology and Community Health at the Medical College of Virginia, Virginia Commonwealth University. Select to register for this teleconference. Exit Disclaimer

8. Registration Now Open for Full-Day HCUP Data Users' Workshop on September 15

AHRQ's Healthcare Cost and Utilization Project (HCUP) is sponsoring a free, one-day workshop on September 15 at the AHRQ Conference Center in Rockville, MD, focused on conducting revisit analyses using HCUP State data. The instructor-led workshop is targeted at intermediate-level data users or people who are familiar with HCUP. Prior experience with HCUP databases, prior attendance of HCUP overview presentations, or completing the online overview course is encouraged. Computers will be provided, and programming examples are presented in SAS. HCUP is a family of health care databases, software tools, research publications, and support services created through a Federal-State-Industry partnership. HCUP is used for a broad range of health services research and policy issues at the national, State, and local market levels, including cost and quality of health services, medical practice patterns, access to health care, and outcomes of treatments. The workshop fills quickly, so early registration is encouraged. Select to register.

9. AHRQ in the Professional Literature

We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.

Anderson WG, Pantilat SZ, Meltzer D, et al. Code status discussions at hospital admission are not associated with patient and surrogate satisfaction with hospital care: results from the multicenter hospitalist study. Am J Hosp Palliat Care 2011 Mar; 28(2):102-8. Select to access the abstract on PubMed®.

Curry LA, Spatz E, Cherlin E, et al. What distinguishes top-performing hospitals in acute myocardial infarction mortality rates? A qualitative study. Ann Intern Med 2011 Mar 15; 154(6):384-90. Select to access the abstract on PubMed®.

Devoe JE, Tillotson CJ, Lesko SE, et al. The case for synergy between a usual source of care and health insurance coverage. J Gen Intern Med 2011 Mar 16. Select to access the abstract on PubMed®.

Learman LA, Nakagawa S, Gregorich SE, et al. Success of uterus-preserving treatments for abnormal uterine bleeding, chronic pelvic pain, and symptomatic fibroids: age and bridges to menopause. Am J Obstet Gynecol 2011 Mar; 204(3):272.e1-e7. Select to access the abstract on PubMed®.

Carr BG, Reilly PM, Schwab CW, et al. Weekend and night outcomes in a statewide trauma system. Arch Surg 2011 Mar 21. Select to access the abstract on PubMed®.

Yehia B, Fleishman J, Wilson L, et al. Incidence of and risk factors for bacteraemia in HIV-infected adults in the era of highly active antiretroviral therapy. HIV Med 2011 Mar 23. Select to access the abstract on PubMed®.

Smith DH, Raebel MA, Chan KA, et al. An economic evaluation of a laboratory monitoring program for renin-angiotensin system agents. Med Decis Making 2011 Mar-Apr; 31(2):315-24. Select to access the abstract on PubMed®.

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Current as of August 2011
Internet Citation: Nighttime-Breathing Treatments Backed by Strongest Evidence Among Options to Treat Sleep Apnea: Electronic Newsletter, Issue 322. August 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/322.html