Portal de Periódicos da CAPES

Masking the 6-Minute Walking Test in the COVID-19 Era

2020; American Thoracic Society; Volume: 18; Issue: 6 Linguagem: Inglês

10.1513/annalsats.202009-1088rl

2329-6933

Antonio Salles-Rojas, Carlos Guzmán-Valderrábano, Wilmer A. Madrid, Amaury González-Molina, Mónica Silva-Cerón, Christian Rodríguez-Hernández, Isabel Salas-Escamilla, Armando Castorena-Maldonado, Carlos Alberto López-García, Luis Torre‐Bouscoulet, Laura Gochicoa‐Rangel,

Noise Effects and Management

testing preference where the most frequent reason for preferring home-based testing was "sleeping in one's own bed" (4, 5).We also found that PAP adherence did not differ by PAP initiation strategy, consistent with clinical trial results (6, 7).This is reassuring given concerns that durable medical equipment support for home-based initiation in the real world is lower than what has been provided in clinical trials.However, we did find that adherence was significantly lower among patients who had PAP initiated in a manner discordant with their personal preference.Specifically, patients who preferred laboratory-based initiation but received home autotitration had the lowest PAP usage.A preference for in-laboratory titration may identify a subset of patients who need higher levels of support to optimize PAP adherence.Unfortunately, we did not collect information about health literacy or self-efficacy to directly test this hypothesis.The results of this study reflect the preferences of patients initiating treatment from an academic sleep medicine clinic.Therefore, the findings may not be generalizable to other patient populations.Furthermore, because patients were recruited into this study, there may be selection biases in who agreed to participate.In addition, this study was conducted before the global coronavirus disease (COVID-19) pandemic, which may lead to changes in how both patients and clinicians weigh the benefits and risks of inlaboratory titration studies (8).Over the last decade, there has been an increasing call toward a sleep healthcare delivery system that encourages patient engagement and incorporates patient values in clinical decision-making (9).Our findings suggest that patient preference should play an important role in selecting a strategy for PAP initiation.Not only does such a strategy hold true to the values of patient-centered care, but our data suggest it may lead to better treatment outcomes.Future research should prospectively assess whether OSA treatment approaches that explicitly incorporate patient preference lead to improved clinical outcomes.