Comparison of Telemedicine Versus In-Person Postoperative Appointments Following Drug-Induced Sleep Endoscopy

ABSTRACT

Introduction: Telemedicine has been a useful tool in the virtual management of patients with sleep disorders during the COVID-19 pandemic. Given the detrimental effects of chronic, untreated obstructive sleep apnea (OSA) on patient health, it is important that patients receive timely care. This study investigates whether the use of telemedicine is associated with delays in care or different rates of patient follow-up after drug-induced sleep endoscopy (DISE). Method(s) We performed a retrospective review of 166 patients who underwent DISE during 4-month periods of March-June 2019 and March-June 2021. The efficiency of telemedicine vs inpatient appointments following DISE was assessed using the time from DISE to the patient's first postop visit and the time from that postop visit to surgical intervention, referral to another specialty, or clinic follow-up. Additional variables of interest included patient demographics, characteristics of their OSA (sleep study results, Epworth score, positive airway pressure use), and the type of further care received (clinic follow-up, referral to another specialty, or surgery). Result(s) There was a significant increase in the rate of initial post-DISE telemedicine visits during the COVID-19 pandemic, with 39.7% of visits being telemedicine (P<.001) compared with 13.0% of visits pre-pandemic. The use of telemedicine was not associated with significant delays in obtaining initial post-DISE appointments, further surgical interventions, specialist referrals, or clinic follow-ups. There were no significant differences in follow-up rates between inperson or telemedicine appointments. In addition, there were no significant differences in telemedicine usage among patients of various demographics or with different severities of OSA compared with in-person appointments. Conclusion(s) Telemedicine appointments are an efficient alternative to in-person appointments following DISE for the management of OSA. In this setting, telemedicine was not associated with any significant delays in patient care or decreased follow-up rates, even among various patient demographics.