Yale University School of Medicine, Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, New Haven, CT, USA.
Yale University School of Medicine, Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, New Haven, CT, USA.
Sleep Med Rev. 2018 Feb;37:138-147. doi: 10.1016/j.smrv.2017.02.004. Epub 2017 Feb 24.
Obstructive sleep apnea is a common condition, with multiple potential neurocognitive, cardiovascular, and metabolic consequences. Efficacious treatment is available, but patient engagement is typically required for treatment to be effective. Patients with sleep apnea are phenotypically diverse and have individual needs, preferences, and values that impact treatment decisions. There has been a shift in obstructive sleep apnea management from diagnosis to chronic care management. Making treatment decisions that incorporate an individual patient's values and preferences and are personalized for that patient's biology has the potential to improve patient outcomes. A patient-centered care approach in obstructive sleep apnea is reviewed including 1) determining patient-specific needs to guide treatment decisions, 2) understanding patient values, preferences, and other factors impacting treatment decisions and using shared decision-making, 3) enhancing patient education and support to improve treatment adherence, 4) promoting patient engagement, 5) optimizing care coordination, continuity of care, and access to care, and 6) determining and assessing patient-centered outcomes.
阻塞性睡眠呼吸暂停是一种常见病症，可能会引发多种潜在的神经认知、心血管和代谢并发症。目前已有有效的治疗方法，但患者的配合对于治疗效果至关重要。患有睡眠呼吸暂停的患者表型多样，且具有不同的个体需求、偏好和价值观，这些因素会影响治疗决策。阻塞性睡眠呼吸暂停的管理已从诊断转向慢性疾病管理。做出既能体现患者个体价值观和偏好，又能根据患者生物学特点量身定制的治疗决策，有潜力改善患者的预后。本文综述了以患者为中心的阻塞性睡眠呼吸暂停治疗方法，包括：1）确定患者的具体需求以指导治疗决策，2）了解影响治疗决策的患者价值观、偏好和其他因素，并采用共同决策，3）加强患者教育和支持，以提高治疗依从性，4）促进患者参与，5）优化护理协调、连续性和可及性，6）确定和评估以患者为中心的治疗结局。
