Clinician Attitudes and Knowledge of Pediatric Sleep-Disordered Breathing.

Abstract

Objectives: The goals of this study are to assess primary care provider (PCP) knowledge of and attitudes toward pediatric obstructive sleep apnea (OSA), and to identify variations in practice patterns.

Design: A cross-sectional survey including the Obstructive Sleep Apnea Knowledge and Attitudes in Children (OSAKA-KIDS) questionnaire was administered to PCPs from August to December 2021. Univariable analyses and multivariable linear regressions were performed to analyze associations between demographics and knowledge, attitudes, and screening frequency.

Results: Eighty-two PCPs completed the survey (age 43.4 ± 9.6 years, 69.6% female, 90.2% non-Hispanic White). Specialties included Pediatrics (65.9%) and Family Medicine (32.9%). Respondents answered a mean 84.9 ± 10.7% questions correctly on the knowledge portion. Years in practice, provider training, and academic affiliation were not associated with knowledge scores. Less than half (45.1%) of respondents screened for OSA "most of the time" (32.9%) or "always" (12.2%). Higher screening frequency was associated with clinics with higher Medicaid beneficiaries (P = .002) and a lower proportion of Black patients (P = .033). Providers who felt more confident in managing OSA were more likely to screen "most of the time" (B = 0.532, 95% CI [0.120-0.926], P = .012), or "always" (B = 0.708, 95% CI [0.129-1.29], P = .017).

Conclusion: these results suggest guideline-recommended screening for OSA is low among PCPs. Higher confidence in OSA management was associated with higher screening rates. Further studies on interventions aimed to increase screening and confidence may improve equitable care.