New Zealand primary health care practice regarding compliance management of obstructive sleep apnoea treatment in heavy transport driver licence holders

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Authors
Garrett, Sarah
Author ORCID Profiles (clickable)
Degree
Master of Nursing
Grantor
Eastern Institute of Technology (EIT)
Date
2018
Supervisors
Thompson, Shona
Type
Masters Thesis
Ngā Upoko Tukutuku (Māori subject headings)
Keyword
New Zealand
obstructive sleep apnoea
heavy transport driver licence holders
patient care
treatment
compliance management
primary health care
surveys
ANZSRC Field of Research Code (2020)
Citation
Garrett, S. (2018). New Zealand primary health care practice regarding compliance management of obstructive sleep apnoea treatment in heavy transport driver licence holders. (Unpublished document submitted in partial fulfilment of the requirements for the degree of Master of Nursing). Eastern Institute of Technology (EIT), New Zealand. https://hdl.handle.net/10652/6047
Abstract
BACKGROUND Obstructive sleep apnoea (OSA) is a chronic health condition that can affect a person’s driving ability due to impaired cognitive function as a result of having inferior quality and disrupted sleep. Holders of heavy transport (HT) driver licences have been identified as an ‘at risk’ group with higher rates of OSA which, if left untreated, can lead to increased incidence of road traffic accidents (McNicholas, 2005; Thoracic Society of Australia and New Zealand (TSANZ), 2004). The New Zealand Transport Authority’s (NZTA) guidelines (2014) states that medical follow-up of HT drivers diagnosed with OSA can be delegated to a General Practitioner (GP). Also, with increasing pressure on specialists in secondary care, primary health care (PHC) providers are being encouraged to become more involved in the care and management of OSA in ‘at risk’ populations. AIM To find out how New Zealand PHC providers are managing OSA treatment of patients who hold HT drivers licences. The objective of the research was to identify areas where possible improvements could be made in the long-term management of OSA in the PHC setting. METHOD The research utilised a quantitative design approach, employing an anonymous online survey of 24 healthcare professionals in PHC which included GPs, Nurse Practitioners (NPs) and Registered Nurses (RNs). The survey questioned their current practice related to caring for patients on treatment for OSA who held HT licences and enquired about their understanding of OSA terminology. FINDINGS The research indicated that the PHC healthcare professionals surveyed showed an awareness of the importance that holding HT drivers licence has in relation to OSA. Management of treatment compliance was guided by the NZTA policy (2014) and treatment recommendations supplied by the specialist provider. A majority of respondents felt that they only had an ‘ok’ understanding of sleep medicine terminology and that there is a reliance on secondary care to obtain objective treatment data. CONCLUSION With the increasing burden of managing the complications of chronic health conditions within secondary care, the role that PHC plays in the management of chronic conditions becomes increasingly important. The research showed that some healthcare professionals working in PHC in New Zealand considered improvements are needed to enhance the future of OSA treatment, compliance and management in the PHC setting. Suggested improvements included addressing the PHC professionals perceived lack of clarity with the current NZTA driver licence guidelines, reviewing collaboration between PHC and secondary providers via review of care pathways and review of the potential role RNs and NPs in compliance management of NIV/PAP treatment in PHC.
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